Written by Dr. Anna Kroncke, licensed psychologist and Co-Founder of Cadey.
As a mother of a preschooler, I’m continually surprised by how difficult it is for well-meaning parents to find reliable resources about developmental evaluations. Qualified clinicians with availability are difficult to find, pediatricians are often unable to provide quality referrals, and parents often come away hearing ‘wait and see’ putting off any meaningful support for years.
As a clinician, I’m committed to making the evaluation process more accessible for families. In this article, I’m going to help you understand the value of a comprehensive assessment, what it entails, and how to take action if you’re concerned about your child’s development.
A comprehensive assessment (or comprehensive evaluation) looks at a number of different areas of a child's development and functioning. Assessments analyze a wide range of abilities and are conducted by certified providers like psychologists, developmental pediatricians, or a multidisciplinary team that may include a speech therapist, occupational therapist, or learning therapist.
Comprehensive evaluations are designed to test a child’s:
Assessments can also evaluate other areas such as academics, attention, executive functioning, memory, and sensorimotor skills.
An assessment across a number of areas provides a full picture of a child’s skills and abilities at that time. It does not just focus on one skill or concern, but offers a more holistic view.
A comprehensive assessment can identify areas of need that may be related to, but different from, a parent’s primary concern. For example, an assessment for a teenager with spelling challenges will be academic only. However, a clinician conducting a comprehensive evaluation may discover other areas of concern, like social skills or emotional symptoms.
Research shows that identifying risk factors as early as possible can help reduce mental health challenges later on. This is especially true for school-age children who are going through several major changes in their social and cognitive development.
While receiving a formal diagnosis may be daunting, it unlocks a suite of funding and support services. For example, patients may receive:
While there are many different kinds of therapies and supports available, parents need to know where to focus their time and attention. A comprehensive assessment will have recommendations for what parents can prioritize.
Comprehensive assessments help identify both a patient’s strengths and weaknesses. This enables providers to use a child’s strengths to build confidence and self-esteem, and to work on areas of weakness. For example, a child with great verbal and memory skills who has trouble with social conversations will be good at remembering things to say. A therapist can work on conversation ideas before a social outing and know the child has a strength in using language and memory. This information may impact how a therapist can work with the child.
The most important part of a comprehensive assessment, in my opinion, is not the diagnosis but rather the prioritization of next steps. Parents want to know how they can best help their child now while simultaneously preparing them for the future. Maybe a child has delayed language development and poor fine motor skills. Working on language would be the first priority and parents may be glad to have the guidance toward an expert speech therapist who treats language delay. Fine motor skills can be addressed as language starts to improve.
If you have concerns about your child, here are some suggestions for your next steps:
Back to my recent experience as a parent. Another mother with concerns that her preschooler had ADHD approached the pediatrician for a referral. She was told that she could wait 2 years on a waitlist at Children’s Hospital Colorado or take a referral to an occupational therapist. As Wayfinder knows and offers to parents everyday, there are not just 2 options for a concerned parent here in Colorado. This parent was led to believe that occupational therapy was the same as a comprehensive assessment. Luckily, I was able to offer her information about Wayfinder and referrals to a number of great practices offering assessments more immediately. Most parents don’t get that.
A recent compilation of comprehensive assessment practices in the Denver/Boulder area who were taking new referrals provided by Dr. Lila Kimel, a private practice psychologist, noted more than 24 psychological assessment practices with expertise in child development, autism, ADHD, anxiety, learning and related areas. This is not even a comprehensive list, but shows the mismatch between information parents are provided by their pediatricians and what actually exists in our community.
If a parent is guided to a specific therapy without a full understanding of their child’s profile and needs, it is possible that they will go for years without identifying important support for their child. A sensory need might be noticed but an attention challenge or an academic need could be missed. We all understand the importance of early intervention (McMorris 2013;Gordon-Lipkin 2016) and want to help families early and in all areas of need.
Dr. Anna Kroncke is a licensed psychologist and nationally certified school psychologist. She has worked in schools and a traditional clinical practice with other psychologists, ABA therapists, and has supervised graduate students in school and counseling psychology. Dr. Kroncke is an expert in autism diagnosis and co-authored an Autism Assessment textbook published in 2016 and downloaded by more than 90,000 clinicians.
Beginning in 2018, Dr. Kroncke and her partner Dr. Marcy Willard developed CADE, a widely used autism assessment for clinicians in school and clinical settings. In March of 2022, they launched a free parent assessment for parents with developmental, behavioral or emotional concerns for their children called Cadey. Dr. Kroncke and Dr. Willard continue to train clinicians in schools and clinical settings, and regularly offer talks on a variety of mental health topics. They also offer coaching to families within the Cadey platform. Dr. Kroncke and Dr. Willard’s virtual clinical practice Clear Child Psychology offers assessment and consultation services to families. You can learn more at cadey.co.