Epilepsy: Assessing your child's learning needs

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Read about why your child with epilepsy may require a psychoeducational assessment, who will perform it, and what it may consist of.

Key points

  • Many children with epilepsy experience some sort of learning or academic challenges.
  • A needs assessment may be done if you or your child’s teacher is concerned about academic performance, language development, social development or classroom behaviour.
  • A psychoeducational assessment may be used to better understand your child’s strengths and needs relative to their age or school grade peers.
  • Results of a psychoeducational assessment are shared with you verbally and in a written report. This report will include recommendations for your child.
  • With your consent, the information can be shared with your child’s school, school board and treatment team.

Why an assessment of your child’s learning may be needed

Epilepsy is a complex disorder of the brain characterized not only by seizures but also by the cognitive, psychological (behavioural and emotional) and social consequences of the condition.

Many children with epilepsy experience some sort of challenge related to their learning or academic progress. Irritability, frustration and worries are also common.

A needs assessment may be done if you or your child’s teacher observes that your child is:

  • having trouble keeping up with lessons
  • having trouble engaging in the learning environment
  • appears slower in their language or social development than their peers

A needs assessment may be done at the school to outline what steps should be taken to ensure that your child receives appropriate support.

In many school boards, the concerns will first be brought forward at a Special Educational Resource Team (SERT) meeting. The meeting involves you as well as an in-school team including your child’s teacher, an administrator such as a vice-principal, a special education teacher if one is present in the school and the relevant consultants who are attached to the school. Most school boards are set up so that small groups of schools in a district are served by a school psychologist or psychoeducational consultant, a speech and language pathologist, a special education resource teacher and a social worker.

Steps involved include:

  • Your child’s teacher presents the concerns at the SERT meeting.
    • Strategies are recommended and an action plan is developed which may include in-classroom accommodations and/or resource support, or a recommendation for a psychoeducational assessment.
  • Your child’s needs may be brought before the in-school team a second time before the recommendation for assessment is made.
    • If the issues are primarily language based, a speech and language assessment may be recommended.
    • If the issues are primarily related to the physical execution of writing, an occupational therapy assessment may be recommended
    • If the issue is primarily behavioural or academic, a psychoeducational assessment may be recommended.

How long does it take to arrange a psychoeducational assessment?

If an assessment has been recommended by the school team, as a parent you must first consent to the process.

Because of financial constraints and the demand for service, the wait for a psychoeducational assessment can be long: six months to two years in some school boards. In some cases, psychological or psychoeducational assessments can be arranged at local hospitals or community health resource centres. If resources allow, you might wish to consider arranging for a private psychoeducational assessment. A portion of the cost for private assessment may be covered for families with extended health benefits.

What happens during a formal psychoeducational assessment?

Assessments are completed face to face with your child in one or two sessions. During these sessions, the psychologist will gather information from your child through observation, discussion, use of standardized tests and use of less formal assessment procedures.

A psychoeducational assessment consists of:

  • interviews
  • observations
  • review of school records and other documentation
  • standardized tests of thinking, reasoning, academic achievement and in some cases other skills such as attention and memory
  • standardized questionnaires to gain an understanding of your child’s functioning in everyday life
  • interpretation of the results from the testing and questionnaires which are shared through
    • discussion of results with you
    • a written report

Interviews

Interviews can be structured or informal. They can be used for many purposes including gathering relevant history, formulating a diagnosis, providing feedback or performing an intervention. The psychological associate or psychologist will interview your child, and you.

Observations

Depending on the age of your child, the psychological associate or psychologist might observe your child in the classroom in addition to the other assessments. This strategy is most effective for younger children . If the issue is behavioural, some observations might be conducted in the home.

Review of documentation

Your child’s complete school record and other relevant documentation that you share such as medical records, reports from other assessments or legal documents will be reviewed.

Standardized tests

Standardized tests are typically the primary source of information used to gain a better understanding of your child’s strengths and needs. They are used to measure skills related to intellectual abilities, attention, memory, academic achievement, behavioural functioning and social-emotional well-being. Standardized tests have been developed scientifically to meet a number of psychometric standards and compare your child’s performance relative to other children of the same age or in the same school grade.

The core standardized tests that are used in a psychoeducational assessment include:

  • Intellectual abilities: Tests of intellectual abilities are sometimes referred to as tests of cognitive ability. These tests are almost always included in an assessment.
  • Academic ability: Tests of achievement are typically included for school-based assessments and are needed to diagnose a learning disability.

For some children, other tests that might be administered to better understand presenting concerns, include:

  • Language, such as tests of vocabulary, language comprehension and language expression.
  • Attention, such as tests that assess your child’s ability to maintain concentration or focus or which evaluate distractibility.
  • Memory, including learning of and retention for auditory (listening) and visual (seeing) information.
  • Graphomotor skills to assess motor development, fine motor control and handwriting.
  • Standardized questionnaires completed by you, your child’s teacher and sometimes by your child to help to gain a better understanding of your child’s behaviour and social-emotional well-being in everyday life.

Once the psychologist has interpreted the results, they can identify your child’s strengths, areas of need, consider potential future challenges and offer strategies that might help them.

Who performs a psychoeducational assessment?

A qualified professional performs the assessment. They are either employed by the school board or families can arrange for the assessment to be done privately in the community. Depending on the school board, this person may be a psychological associate or a school psychologist. Psychological associates have a master’s degree in psychology or educational psychology while psychologists have a PhD. These practitioners will either be a registered member of a College of Psychologists or be supervised by a registered member.

How does a psychoeducational assessment take place?

In a school board setting, you will have consented to the process before arrangements are put in motion. The psychological associate or psychologist will explain the process to your child and get their assent or consent to participate. The psychological associate or psychologist will withdraw your child from class and take them to a private room in your child’s school to perform the assessment. Depending on your child’s age and ability level, the full assessment will take from three to five hours and will be conducted over one or two sessions.

If the assessment takes place in the community, arrangements are made in advance for one or two appointments with the psychologist.

What happens with the results of a psychoeducational assessment?

Once an in-school assessment is completed, the psychologist will provide a written report for you which will also be shared with the treatment team, your child’s school and the school board. The report may include:

  • background information (your child’s history and current concerns)
  • the names of the tests that were administered
  • your child’s results on the tests
  • the psychologist’s interpretation of the results
  • a summary of results and how they are related to epilepsy and development
  • recommendations and referrals to other specialists

The report will be used by the school’s principal, your child’s teacher and possibly the school board, to determine what services or special help your child needs and to develop a learning plan. In some provinces, it may be the only tool that enables your child to get extra services, such as remedial support, special therapy and a self-contained special education class.

Your child may need to be assessed again in the future, to show changes that have happened over time.

Last updated: janeiro 25th 2022