The school psychologist's working model and professional stance in diagnostic assessment

This is an excerpt from a lecture I gave at the Israeli national convention of school psychologists in December 2017.   In this part of the lecture I talked about the school psychologist's working model in diagnostic assessment (at least, as I see it).  Since this model is best implemented with a specific professional stance, this stance will be presented as well.

Here is a diagram of the model:

As you can see, the model consists of three domains: cognitive abilities, emotional abilities, and the child's functioning at school: his general functioning as a student, his reading, writing and arithmetic achievement, and his social and emotional status. I have drawn cognitive and emotional abilities as clouds because these are theoretical. The actual functioning of the child is not theoretical, of course.  Therefore it appears as a square.

In this model, we try to understand how the child's cognitive abilities affect his general school functioning, performance in reading / writing / math  and social and emotional functioning.

We try to understand how the child's emotional abilities affect his general school functioning, performance in reading / writing / math and social and emotional functioning.

We try to understand how the child's cognitive abilities affect his emotional abilities, and how his emotional abilities affect his cognitive abilities.

Of course, the child's background (familial, developmental, etc.) affects his emotional and cognitive abilities as well as his actual functioning, and we consider that as well. I did not represent the background and its influences in the model, for the sake of graphic simplicity.

Let's look at an example of each of these types of effects.

As an example of the influence of cognitive abilities on a child's functioning, we would imagine a child who has poor comprehension knowledge.

How will poor comprehension knowledge affect the child's performance in reading / writing? A child with a poor comprehension knowledge will probably find it hard to express her ideas orally during a lesson, will find it difficult to express herself in writing, will have difficulty with reading comprehension due to difficulties in processing complex syntactic structures, and so on.

How will poor comprehension knowledge affect the child's social and emotional functioning? A child with poor comprehension knowledge will probably find it difficult to express her needs and ideas in words. This may cause social misunderstandings and frustration, which may even be expressed in acting out.

As an example of the impact of emotional abilities on a child's functioning, we will use conceptualization from the SCORS scale. SCORS - SOCIAL COGNITION AND OBJECT RELATIONS SCALE is a scale that tests dimensions of object relations in projective tests. The scale consists of several dimensions, one of which is the Complexity of representation of people. This dimension refers to the extent to which the child represents people as separate objects, each with a rich and different inner world.

How can poor complexity of representation of people affect the emotional and social functioning of a child? Such a child will find it difficult to distinguish between the points of view of himself and others in social situations or to take others' point of view in social conflict.  He will find it difficult to see himself and others as psychological entities with subjective motivations and experiences. This may lead to misunderstandings and exacerbate social conflicts.

How can poor complexity of representation of people affect a child's learning? When such a child reads text, for example, he will find it difficult to infer from the overt content the thoughts, feelings, perspectives and internal motives for the behavior of different characters. This may cause difficulties in reading comprehension.

How can emotional abilities affect cognitive abilities?

We know, for example, that a persistent state of stress can impair short-term memory and executive functions.

How can cognitive abilities affect emotional abilities?

When a person's ability to visualize scenes (part of her visual processing ability) is impaired, her ability to make decisions in social situations may be compromised because she may find it hard to create a visual image of the social situation "a few steps forward".  Furthermore, we usually make decisions based on past experience with similar social situations.  In order to do that we use our episodic memory.  The ability to retrieve a vivid episodic memory is highly dependent on the ability to create a visual image of the event we want to remember.  A child with poor visual imagery may reconstruct a vague episodic memory (in terms of her ability to "see" the event in hier mind's eye).   This may dampen the experienced emotional intensity of the event and compromise the child's ability to learn from it. 

After looking at all the interactions, let's consider the whole model again. When using this model, we try to understand how the child's strengths and weaknesses are reflected in the interactions. In light of this, we try to understand what the child needs from his environment.

Why is this model so good?

Because it requires us to provide an explanation, not only to describe the child's status! It is not enough for the psychologist to describe the state of the child's cognitive abilities, the state of the child's emotional abilities, the child's performance in reading/writing/math and   the social and emotional status of the child. This kind of diagnostic work is not good enough. This model requires the psychologist to show how a child's cognitive abilities can explain his functioning at school, how his emotional abilities can explain his functioning at school, how his cognitive abilities affect his emotional state, and how his emotional abilities affect his cognitive state. The explanations that link the child's cognitive abilities, emotional abilities, and school functioning constitute the heart of the model. Good diagnostic work must include explanations.

These explanations provide us with a way to make a change in the life of the child, his parents/family and his teachers.  These explanations help our clients (the child, the parents and the school staff) to create a new narrative about themselves, about the problem and about how to deal with it.

But if we want an explanation to convince our clients, we have to build it with them. If we present them with our explanation, and expect them to accept it, we'll have much less success than if they take part in the construction of the explanation.

Therefore, it is impossible to work with this model without an inclusive, collaborative stance toward our clients.

The stance of the educational psychologist in the diagnostic intervention is an inclusive, collaborative stance. We see the child, the educational staff and the parents as partners in the "investigation" of the problem.   The inclusive stance helps us to emphasize the child's   strengths, and not to pathologize him.  The "temptation" to pathologize is stronger when the psychologist takes a distant, paternalistic stance.  But the educational psychologist works from a proximal, egalitarian stance. Thus, the diagnostic intervention can also become a therapeutic intervention.

We see the child as our partner.

The child is our co-investigator of the problem. We ask him: What do you think causes your difficulties? When do you cope successfully with the problem? What helps you cope? What are your strengths? And so on.

The child is our co-investigator of her thinking processes. During the diagnostic intervention we ask the child: What led you to this answer? What were your thoughts? What helped you succeed in this task? Did checking your work help? Did encouraging yourself help? Did thinking a little more before answering help? Did having more time help? Did the questions I asked you help?

The child is our partner for reflecting on our interaction during the diagnostic intervention. Some time ago I asked an adolescent girl to answer a question about a text she had read. The girl refused to write the answer and said she was used to answering only orally. I let her answer orally. Her answer was very good. I told her: "Your answer is excellent, now write down exactly what you told me." The girl did so, and the written answer was also excellent. This immediately led to a conversation about what happens to this girl when she deals with similar tasks.  The girl said that she prefers not to write because she does not want to see that she is wrong. This led us to talk about what can strengthen the girl's self confidence, and about the price the girl pays for her avoidant behavior.

Thus during the diagnostic intervention the child learns about himself. Our inclusive, collaborative stance -  seeing the child as our partner -  helps her take responsibility for herself and for the problem, and take an active position towards the problem.

The educational staff is also our partner in the investigation of the problem and the search for solutions. When a teacher and a psychologist try to understand a child's persistent reading comprehension difficulties, they can raise hypotheses in line with the above model.  For instance, it is possible that the child does not believe that he can cope independently, needs a lot of reassurance and that's the reason he needs help from the teacher. It is possible that a child has poor comprehension knowledge or poor CALP which make it difficult for him to understand the text.  He may have poor vocabulary or find it difficult to derive meaning from the complex syntax of the text. Another possibility is that the child may find it difficult to infer things not written explicitly in the text, or to integrate details in the text.  This may result from poor fluid ability.

The teacher and psychologist can think how the teacher can test some of these hypotheses with the child.  Then, after the teacher has a clearer picture, the psychologist and teacher can think how to help this child, how to help children with similar characteristics in the teacher's classroom, how the school deals with reading comprehension, what can be changed and what the teacher needs from the school system.

In this example the diagnostic intervention took place without the psychologist meeting directly with the child and testing her. Nevertheless, this is a diagnostic intervention too!

The child's parents are also partners in "the investigation" of the problem. As part of the interview with the parents, we can ask, for example, if others in the family are dealing with the same problem.  If so, how does each of them cope? What works against the problem and what doesn't? What have they tried? How can they help the school deal with the problem? And in general - what strengths do the parents see in their family and in the child? What does their life look like in areas the problem has not affected?

There is no doubt that the insights that parents can add to the understanding of the problem can help us create a richer and more accurate picture of the state of the problem in the life of the child.

We see our clients - the parents, the educational staff and the child as partners in our quest to understand the problem, to search for solutions, and to construct an intervention plan.

When a school psychologist meets with the parents, the school staff and the child to summarize the diagnostic intervention, she presents her view of the problem.  But this meeting is an expert meeting:  the teacher has pedagogical expertise and a large "toolbox" from which she can choose interventions.  The parents have expertise in parenting this child and their other children. The child has expertise in being himself… The psychologist would like to hear how the things she had seen fit with what the parents, the teacher and the child see from their point of view. Together this team of experts build the story about the problem and how to deal with it. This shared understanding helps parents think about what they can take upon themselves to do. It helps the teacher think about what she can undertake to deal with the problem successfully. This shared understanding, achieved during the diagnostic process, helps the child to think about what he can undertake to minimize the problem and to begin the construction of a new and more successful story.

The insights that have been reached in the feedback session and the treatment plan can be written in the psychodiagnostic report, and serve as a realistic intervention that the clients will be happy to implement because they participated in its making.