Dr. Hale is committed to an evaluation process that includes timely feedback, both verbally and in writing.  Feedback sessions to discuss findings are typically scheduled within a week of final assessment sessions, and a written report is mailed within approximately one week of the feedback. 

Some psychological and neuropsychological practices use someone called a psychometrist, testing assistant or neurocognitive assistant.  This person is usually a bachelors-level, unlicensed employee who works directly with you or your child to administer and score tests that the psychologist later interprets.  

Dr. Hale performs all of her own testing and conducts each assessment personally.  She does not have any employees, supervisees, interns, psychometrists, testing assistants, techs, associates or students taking part in any aspect of the evaluation process.  

Dr. Hale believes that a meaningful evaluation is dependent on taking the time to get to know you and/or your child, on directly observing the unique process and approach that lies behind a test score and on accurate, first-hand interpretation of assessment results.

The evaluations conducted by a clinical psychologist in private practice are very different from the evaluations conducted by a school psychological service provider or school psychologist specialist in a child’s school.  These differences also apply to evaluations completed by a private school student’s local school district (the district within which the private school, not the student, resides).  Some differences that parents are most interested in understanding are:

Confidentiality:  School-based evaluations are a permanent part of a child’s educational record and automatically shared with a child’s school team.  Similarly, all results from a CDS evaluation are shared with the team determining eligibility for services and with a child’s public school when transitioning to kindergarten.   

Evaluations conducted by a psychologist in private practice are only shared with others when parents give explicit permission to do so. 

Person conducting the evaluation:  Often, a referral for special education or early intervention services includes evaluations by two or more evaluators (e.g., school psychologist, special education teacher, speech and language clinician, instructional strategist, occupational therapist, physical therapist, behavior strategist), all of whom are employed by or under contract with the school department or CDS.  

For the psychological portion, most evaluators working for public school districts have a master’s degree in school psychology and are trained to work with children and adolescents in a K-12 school setting.  Their training emphasizes assessing students in order to gain information that guides educational decisions made by your child’s school team and supporting students within their school environment.

A clinical psychologist in private practice is not employed by your child’s school or by CDS and practices independently of any school regulations, policies or requirements. They have a doctoral degree in clinical psychology.  Clinical psychology is a psychological specialty that emphasizes continuing and comprehensive mental and behavioral health care for individuals and families across all ages and across diverse settings.  These settings may include schools (spanning early childcare settings and preschools to graduate universities), hospitals, outpatient clinics, community organizations, workplaces and research institutions.  

In contrast to the separate, domain-specific evaluations completed by several different evaluators as part of the special education or early intervention process, a clinical psychologist conducting a comprehensive evaluation in private practice will often include and integrate assessment measures shared by other disciplines (e.g., academic, language, fine motor, behavior, adaptive development).  

Purpose of the evaluation:  The purpose of most school-based evaluations is to inform whether a student has a disability as defined by the Individuals with Disabilities Education Act (IDEA).  Evaluations for younger children that are conducted by CDS – which, like school districts, falls under the supervision of the Maine Department of Education – are also for the purposes of identifying a disability in accordance with IDEA.  

The purpose of a private practice evaluation with a clinical psychologist is to address the unique set of questions and concerns that parents and children have about any number of issues related to learning, attention and other executive function skills, processing, memory, problem solving, language, social communication, social skills, friendships and interpersonal relationships, resiliency, levels of independence, family dynamics, behavior, anxiety, depression, anger, self esteem, overall mental health and coping capacity for various types of stressors and transitions (e.g., relocation, birth of a sibling, parent separation, new school, death of a loved one, traumatic events).

Scope of the evaluation:  There are thirteen possible disabilities under which children ages 6-20 may be evaluated and identified for special education by their public school district.  That number increases to fourteen for children ages 3-5.  Children under age 3 are identified as either having developmental delay or as having a condition with a high probability of resulting in developmental delay, as defined by state and federal regulations.  

The scope of evaluations conducted by school districts and CDS is limited to the information that school/early intervention teams consider relevant to a suspected disability within those 13-14 choices.  Generally, school-based evaluations do not yield a diagnosis, and recommendations for services outside of school are not suggested.  Moreover, special education is a deficit model whereby school and CDS teams are tasked with measuring whether a child’s skills are below a pre-determined level of impairment that would qualify them for services.  

The breadth and depth of evaluations conducted by a clinical psychologist in private practice are collaboratively determined in response to the questions and concerns shared by parents, children, teachers, pediatricians, psychiatrists, therapists, counselors, case managers, tutors and/or other providers.  

When diagnostic clarification is a question of concern, a clinical psychologist in private practice is able to confirm or rule out a diagnosis based on the diagnostic system used by providers across multiple disciplines (psychologists, pediatricians, family physicians, neurologists, social workers, psychiatrists).  This diagnostic system classifies over 200 mental health and neurodevelopmental conditions and is distinct from the 13-14 disability categories identified by CDS and schools. 

The scope of a private practice evaluation may also extend to include a comprehensive understanding of a child’s strengths and recommendations across many avenues of support (home, school, community settings and multi-disciplinary providers).  It is important for parents to understand that CDS and school districts are not required to implement the recommendations made by an outside provider (see FAQ titled:  We had an evaluation done by another psychologist or neuropsychologist.  Why won’t our school district accept it?).

Feedback:  Parents receive feedback about CDS or school-based evaluations in the form of a written report.  Special education regulations dictate the components and the purpose of the report.  Special education regulations additionally dictate that reports cannot speak to eligibility or placement, as these are determined by the school or CDS team and not individual evaluators.  After final reports are written, results are verbally reported out on at a meeting with other members of a child’s early intervention or school team (e.g., teachers, school administrator, other evaluators, school counselor, therapists).  

Clinical psychologists conducting evaluations in private practice provide feedback in a multitude of ways.  All psychologists are required to keep a written, confidential record of an evaluation.  However, the content, format, length and style of written evaluation reports are variable and informed by the psychologist’s areas of expertise and the potential uses of the evaluation report.  

Many clinical psychologists also review findings through a face-to-face feedback with parents.  In Dr. Hale’s practice, this is a private, collaborative discussion that occurs before the completion of the final written report.  In many cases, Dr. Hale also conducts follow-up consultation sessions with children and adolescents in order to provide psychoeducation and to de-mystify their learning and other challenges they may be experiencing.  

School districts are not required to accept evaluations by evaluators who are not employed by the school and who are conducting evaluations outside of the formal special education or 504 referral process.  Special education regulations only require that school districts “consider” outside evaluations.  Some of the most common reasons why an evaluation may not be considered or may be only partially considered by a school district are: 

• In the case of consideration by an IEP team:  The evaluation did not assess for or clearly document results that align with IDEA’s disability definitions (e.g., a pattern of inattention and/or hyperactivity-impulsivity for Other Health Impairment; measures of adverse effect for Other Health Impairment, Autism and Emotional Disturbance; confusion between a diagnosis of Specific Learning Disorder and eligibility criteria for Specific Learning Disability; confusion between a mental health diagnosis and eligibility criteria for Emotional Disturbance).

• In the case of consideration by a 504 Accommodation team:  The evaluation did not provide findings or clear documentation of a mental or physical impairment and/or did not address what major life activity or activities may be limited.

• The evaluation did not address how the disability is demonstrated in the school setting by including school-based input and assessment data (e.g., review of school records, teacher and school staff interviews, standardized teacher rating scales, classroom observation).  

• The conclusions and/or recommendations were not based on or derived from evaluation results (e.g., a diagnosis of Autism Spectrum Disorder when there were no measures of autism spectrum symptoms, a recommendation for speech and language therapy when no aspects of language or communication were assessed).  

• Diagnostic clarity was not provided, limiting the degree to which results could inform educational planning.

• Recommendations were not evidenced-based practice.  

• The evaluation relied on outdated, unstandardized and/or invalid assessment measures.  

• The evaluation relied on only one test, measurement or data source.

• The evaluation contained errors in scoring, documentation or interpretation.

Dr. Hale appreciates that delaying an evaluation based on a wait-and-see approach takes into account the varying paces at which young children develop, the wide range of what may be considered typical for meeting developmental milestones and the possibility for catching up to peers before trying to assess for any measurable delays.  

Dr. Hale also recognizes that this wait-and-see approach has the potential to miss areas that would benefit from early intervention.  The benefits of early intervention are one of the most well-researched findings in the field of child development.  Numerous studies attest to powerful short- and long-term impacts of identifying and addressing early differences, delays and challenges for young children.  This is true across a range of potential concerns (e.g., language delays, social and autism spectrum-related challenges, mental health, learning disabilities, behavioral difficulties). 

Some practitioners and educators believe that children under age 6 are too young to test and that the results will not be valid.  This is a myth.  There are research-based assessment instruments for infants, toddlers and preschoolers.  When integrated into a comprehensive evaluation conducted by an evaluator who has specific expertise with these age groups, these instruments provide meaningful and valid information about social, language, cognitive, motor, adaptive, emotional and neuropsychological development.  

Through partnerships between parents, educators, pediatricians, therapists and other providers, this information is used to guide intervention planning and educational decision making.  In Dr. Hale’s practice, parents often use findings from their young child’s evaluation to guide their parenting and day-to-day approaches to supporting their child within home and other family settings.  

The process of asking for and receiving accommodations in college and graduate school is different than in high school.  Each college and university has its own requirements for documenting the presence of a disability and the related need for accommodations.  

In Dr. Hale’s experience ensuring that her evaluations align with the specific requirements of the colleges and universities attended by older students in her practice, a prior 504 Accommodation Plan or Individualized Education Program is not always necessary.  It is important to also recognize that having a plan in place during high school is often insufficient for obtaining continued accommodations in college.  Particularly for students with learning and attention-deficit disabilities, required documentation usually includes a recent evaluation.   

A psychiatrist is a physician with specialized training in the biological aspects and medical treatment of mental illnesses.  Psychiatrists prescribe medications that impact mood, anxiety, attention, thinking and/or behavior.  Some psychiatrists also provide therapy.  Typically lasting anywhere from forty-five minutes to two hours, psychiatric evaluations rely heavily on interviews and are geared toward arriving at accurate diagnoses and treatment.  These diagnoses are distinct from the disabilities under which children are identified for special education services by CDS or a school team.

A psychologist is not a medical doctor.  In most cases, psychologists cannot prescribe medication. There are a few states that grant prescription privileges to psychologists who undergo added training.  Maine is not one of these states.  Psychologists have a doctoral degree (PhD, PsyD, EdD) and advanced training in biopsychosocial assessment, treatment, prevention and research across the lifespan.  

Comprehensive psychological evaluations typically last several hours and occur over multiple appointments or sessions.  They rely on a range of assessment procedures, including interviews, observations and standardized testing instruments that measure different domains of functioning and development.  The outcomes and uses of a psychological evaluation are diverse and dependent on the unique questions and concerns for the individual being evaluated (e.g., provide diagnostic clarification; inform educational, vocational and/or intervention planning; highlight learning style and profile; understand areas of resiliency; measure progress and responses to intervention).  

The impression that children and adolescents need to be evaluated a second, third or fourth time partly stems from the requirement that public schools evaluate students receiving special education services every three years.  There are also some hospital-based and community-based assessment clinics that automatically recommend reevaluation on a one-, two- or three-year schedule.  

Dr. Hale does not subscribe to a fixed recommendation that all children or young adults need to be reevaluated at a certain time.  Rather, she believes that the decision to have your child come back to see her for another evaluation is highly individualized.  She also believes that for some children a reevaluation may not be indicated or needed.   

Dr. Hale’s practice does include reevaluations for children and young adults who would benefit from another comprehensive evaluation later on in their development.  The timing of these reevaluations is often determined by major school transitions (e.g., the start to preschool, elementary school, middle school, high school or college), the emergence of new concerns, questions about progress and/or questions about the appropriateness of interventions given progression through various developmental stages.