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.
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.
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