Self-advocacy is a highly useful skill. For this conversation, advocacy refers specifically to a student’s ability to speak up in order to get a need met or a problem solved at school. (I am not referring to expressing ideas or imposing viewpoints on others. This is a different skill set and a different type of advocacy).
“When you really listen to another person from their point of view, and reflect back to them that understanding, it’s like giving them emotional oxygen.” – Stephen Covey
So… how exactly do we help students develop effective strategies for representing themselves and gaining access to what they need?
Step one: Create a safe space for the student to speak up and share thoughts, needs, and desires. Students will make requests for help when they feel supported, heard, and safe.
Step two: Help the student identify and clarify what specifically is needed.
Step three: Explicitly teach self-advocacy skills, such as by exploring different formats for speaking up, what to say, how to say it, and when to say it. You might roleplay conversations, identify specific opportunities or times of day, or help compose emails. Effective self-advocacy comes in many forms – and the form chosen must suit the advocator!
Step four: Process through any barriers. This may involve simply validating how difficult it can be, identifying shame triggers, or using concrete solution-focused problem solving/brainstorming.
Step five: Reinforce and celebrate even the smallest of victories. For example, maybe the student didn’t speak up today and ask that question in class, but they thought about it!
Step six: If student continues to avoid speaking up, dig a little deeper and circle back through steps 1-5. What is really preventing them from communicating their needs and wants?
Try out these tips… see what works… and have fun! Join us for the next podcast, where we’ll continue to “learn about learning” and share ways to help your student (and yourself) live a more positive and fulfilling life.
Today we’ll look at the last piece of the R Solutions for Everyday Living. As previously discussed, each R Solution targets one or more area of executive functioning (EF). This week’s R Solution is: Review and Recharge.
Now is the time to take a break from our EF work, look back at our journey, and review progress! If your students set a S.M.A.R.T. goal, did they accomplish it? Where did they excel, and and where did they get hung up? Parents and students can do this together. Just remember, this should be a positive, constructive process. Just because there’s always room for improvement doesn’t mean we shouldn’t celebrate successes along the way.
Here are some areas to Review: Did our S.M.A.R.T. goal target the real EF deficit? What went well over the previous weeks, and what didn’t? What times or activities caused anxiety, frustration, or “blow-outs”? When/why did things not get done? What tasks or activities on our checklists could be added, deleted, or moved around? Are there any skill “gaps” that got missed? (Tip: Use “I’m wondering…” as a conversation starter)
Recharge: Recharging looks different for everyone, and everyone needs it! Developing and using EF strategies are hard work, and for some, the use of EF strategies will always feel upstream. Therefore, it is important to determine how your child recharges (which they show us through their actions and interests) and build that activity (or that “non-activity”) into their rhythm and routines. (Tip: Put “recharge” on the student’s to-do list!)
Hope you’ve enjoyed this series! Join us for the next podcast, where we’ll continue to “learn about learning” and share ways to help your student (and yourself) live a more positive and fulfilling life.
This is the fifth segment in a series about executive functioning (EF): our “5 R Solutions for Everyday Living.” In this episode, we discuss how and why “Rewards and Reinforcers” can alleviate problems with EF.
Rewards and reinforcers are an important and valuable component for supporting children practice and develop EF skills.
By definition, a “reinforcer” is something that increases the likelihood that a desired behavior will increase. Positive reinforcement is an extremely powerful tool—arguably the most powerful tool you have in your toolbox as a parent or teacher! And the research says positive reinforcement produces faster and longer-lasting results than punishment!
Rewards and reinforcers come in many forms, including “edibles,” experiences, tangibles, activities, and social interactions. Another powerful reinforcer is affirmations! Rewards and reinforcers do not have to be huge or cost money. They can be very simple. Examples include putting a marble in a jar, a sticker on a chart, or keeping a weekly log in a journal. The reward for a completed task or goal could be relaxing with a movie, or spending one-on-one time together with someone special.
When I bring up rewards and reinforcers, parents and teachers are sometimes resistant to the idea because they are not on board with “paying kids” to do things they should be doing anyway. I can totally understand how it might feel this way at first. However, it is human nature to seek what is pleasurable and avoid what hurts. We are wired this way! So, use this innate part of human nature to help your children and students learn skills, build strategies, and find success! And don’t worry, once a strategy or skills is established and integrated into daily living, the need for the reinforcer will fade away.
In addition to serving as an incentive, rewards and reinforcers also help a child self-monitor and mark progress. If you recall, self-monitoring and completing “the final lap” are both EF skills. Reinforcers help the child monitor and mark that a task is complete. For example, when the morning check list is finished, a marble is placed in the jar. Five days of morning checklist completion leads to five marbles. And five marbles might equal an hour of game time with Dad!
In summary, the importance of rewards and reinforcers cannot be overstated. They tap into a fundamental trait of human nature: the tendency to seek pleasure or happiness, while avoiding things that are less enjoyable or lead to suffering. Rewards and reinforcers motivate the behaviors that we want to see in others (rather than punish the behaviors that we don’t want). And, when used correctly, they help an individual monitor progress towards an end-goal. Give these a shot and see what a difference positive reinforcement can make in your child’s life!
This is the third segment in a series about executive functioning (EF): our “5 R Solutions for Everyday Living.” In this episode, we discuss how and why “Reduce” can alleviate problems with EF.
I love this R Solution because it can address all six clusters in Dr. Brown’s Model of Executive Functioning (Activation, Focus, Effort, Emotion, Memory, and Action)! The goal here is to help the student reduce to a single point of focus, which will help the student focus and sustain attention, prioritize, reduce overwhelm and frustration, activate with a starting and ending pointing, etc. There are so many strategies (too many to list in one short article) that really work…so I hope the takeaway is that when in doubt, reduce, reduce, reduce. Below is a list of 5 strategies that really work for students, parents, and teachers:
1. Set a timer and work on one task for a set amount of time. The amount of time will vary depending on the student and the task ,and you may have to experiment to identify the optimal number of minutes (could be 20 could be 55). This strategy reduces attention and productivity to a single point of focus, helps activate and prioritize, reduces stress and overwhelm, reduces load on working memory, chunks larger tasks, and provides a method for self-monitoring and time management. This can be especially useful for ”studying,” “practicing,” and completion of long-term projects. For example, if I say, “study your test.” What exactly does this mean? Setting a timer provides a quantitative measure for a qualitative task. It also promises relief (it will be over in 20 minutes) for mentally fatigued and exhausted students.
2. Declutter. Remove visual, auditory, and tactile clutter in the the learning environment, workspace, bag, folder, planner, desk, room, etc. If the mind is ”cluttered” or disorganized, the environment must be orderly. Also, if you notice increased clutter in the student’s space or belongings, it is a good indication they are overwhelmed.
3. Tighten up your Message: When giving instructions or directions, eliminate unnecessary and only loosely related information, words, and directives. In other words, talk less and stick to key actions and objects. Avoid overtaxing their working memory, diverting their focus, and overwhelming their senses.
4. Give Big Picture (or punch line) First. When giving instructions or directions provide a clear idea of where the activity is headed, when will it be done, and what is the point so that the student can focus on key details, prioritize, and maximize their worming memory capacity.
5. Set SMART Goals. SMART GOALS are Specific, Measurable, Attainable, Reasonable, and Time-specific. I love SMART goals because they help direct focus, break larger goals into smaller goals, set timelines, reduce overwhelm, and help students self-monitor progress. I also love setting SMART goals with students because the aspect of the SMART goal they struggle with, reveals their specific area of executive dysfunction. For example, if the goal is identified as “Work on my Science Project,” I might suspect this student has trouble prioritizing, planning, chunking, sequencing, and self-monitoring.
If you like these strategies, pick one or to work on this week, and see how they go for you. We recommend you don’t try all 5 at once. After all, the point of these is to reduce – not to overload yourself! – Dr. Katen
A Series on Executive Functioning
This is the second segment in a series about executive functioning (EF): our “5 R Solutions for Everyday Living.” In this episode, we discuss how and why to “Reframe and Redefine” problems with EF.
Before we can implement an effective solution in any situation, we must first accurately define the problem. Before we can help a student with any struggle, we must first identify what is really going on. Once we correctly call it what it is, we begin the process of solving the problem without blame and shame and with accountability.
For example, there is a common belief that procrastinators are simply perfectionistic, and the fear of not being perfect interferes with their ability to get started and get it done. There is also a common belief that procrastination is deliberate avoidance. While these might be true sometimes, often there is a different reason—a skill deficit.
So if perfectionism and deliberate avoidance are not the causes…what is going on?! In many cases, the true culprit is a deficit in executive functioning, and specifically in the area of activation.
Correctly reframing and redefining the root of the problem helps (1) avoid blaming and shaming, (2) sets problem-solving in the right direction, and (3) creates space for accountability and success.
Activation is one subset of EF skills and includes getting started, organizing, prioritizing. A deficit in activation is essentially a broken “start button.”
Obviously, the solution to a broken start button (or deficit in activation) is very different than the solution to deliberate avoidance or perfection anxiety. If the start button does not work properly, then that child’s brain needs an override. The override can be internal, such as panic or strong interest. The override can also be external, such as support from a person or a change in the environment (more on this next time).
Before we can help a student with any problem, we must first accurately reframe and redefine the true nature of the problem. There is always more to a student than what we can observe. Behavior is communication. And… when the root of the behavior is mislabeled, we miss what the behavior is trying to tell us, which often leads to unwarranted blaming, shaming, and continued failures.
A Free Presentation Series for Parents with Students of All Ages
Individual Matters hosts a series of presentations for parents of students of all ages. Join Dr. Katen and other local experts to learn about all things that have to do with learning.
The presentations take place on the FIRST TUESDAY of every month for the rest of the 2019-2020 school year. Topics will include:
- Learning Simulations
- ADHD: What is really causing the attention problem?
- Dyslexia and other Learning Disorders
- Auditory and Visual Processing
- Executive Function and Learning
- Learning Styles and Using Strengths to Find Success
- Gifted and Advanced Learners
- Successful Learning Skills: Organization and Homework Strategies
- Autism and Other Social Challenges
- IEPs, 504s, and Advocating for your Child at School
- And many more!
Location: 2530 E. Foresight Circle, Grand Junction, CO 81505
Day/Time: 1st Tuesday of each month, 5:30-7:00pm
If you can make it, please RSVP by email or phone so we can be sure to have enough seats and snacks.
Hope to see you there!
“Shame cannot survive being spoken… and met with empathy.” – Brené Brown
Individual Matters is pleased to bring the Experience Dyslexia® Workshop to Central Kentucky and beyond.
You’ve undoubtedly heard the term “dyslexia.” You probably know it refers to a type of “reading disability” that makes decoding and understanding text difficult, results in poor spelling, and is often associated with left/right confusion.
But you may be surprised to learn that you already know someone with dyslexia. In fact, you are probably surrounded by them! Research suggests that the disability is very common. As many as 15% of the population experiences some form of dyslexia, yet only 1 in 10 are ever diagnosed.
If you are an educator, these statistics may not be surprising. Perhaps you witness the struggles of dyslexia in your classroom every day. Its effects include a wide range of learning-related symptoms, as well as one or more of the following behavioral symptoms:
- Low Self-Esteem
- Family Problems
But regardless how familiar you are with dyslexia, it can be hard to relate to the personal struggles of those who live with the disability. And when we don’t understand another person’s behaviors, we tend to make assumptions about the reasons for them.
When dyslexia is undiagnosed, or its effects are not well understood, those with the disability may be labeled as lazy, oppositional, immature, or dumb. Their childhoods are often characterized by continual and frequent failures, as well as by nonstop criticism from teachers and parents, and teasing from classmates. Not surprisingly, the silent shame of this burden inhibits learning, destroys self-esteem, and can lead to depression and other mental health problems that continue well into adulthood. Even when students have been identified with dyslexia, it may be difficult for parents or teachers to empathize with their struggles.
Fortunately, the International Dyslexia Association has created the Experience Dyslexia® Workshop. Now people without the disability can begin to understand what it’s like to have it.
Empathy and understanding is vital for compassionate teaching and parenting. Understanding what dyslexia feels like helps us to avoid making assumptions, recognize learning problems for what they are, refer for appropriate treatment and interventions, and help children with dyslexia and other learning problems find success. With empathy, we can begin to scaffold individuals in overcoming the challenges of dyslexia – as well as capitalizing upon its many upsides.
At Individual Matters, we are pleased to facilitate the Experience Dyslexia® Workshop – as well as others that focus on learning, teaching, and parenting. These experiences are available throughout Central Kentucky and beyond. They are appropriate for teachers, parents, or anyone else who works with dyslexic individuals and/or wants to understand impacts of living with the disability.
To learn more, or to schedule a workshop with Individual Matters, email us or call (859) 260-1914.
So your school has recommended you get a “learning assessment” for your child… What does this mean?
Perhaps your child’s teacher or counselor has concerns about learning, behavioral, or attention problems. Or maybe testing is required as part of the admissions process for a certain school or program.
As a parent, you may be feeling unsure what to do next. After all, a quick internet search will tell you there are lots types of “learning assessments” available – and variety of people who provide them. But not all learning assessments are the same.
Here are 5 things you should know before scheduling your child for a learning assessment:
1. A learning assessment should be completed by a licensed psychologist.
A licensed psychologist is someone with a doctoral degree (Ph.D. or Psy.D.), legal authorization to practice, and specialized experience/training in psychological testing. Typically, schools (both K-12 and college) will only accept assessments completed by individuals with these qualifications. In most cases, only a psychologist holds the requisite credentials for diagnosing clinical disorders, such as ADHD, specific learning disorders, autism, developmental delays, and intellectual disabilities.
2. Learning assessments should include a comprehensive evaluation of IQ and academic achievement.
“IQ” (intelligence quotient) testing refers to the evaluation of intellectual and cognitive abilities (i.e., verbal and non-verbal reasoning, working memory, and processing speed). Academic achievement testing measures acquired procedural knowledge, skills, and facts related to school (i.e., reading, writing, and math). A psychologist should use “gold standard” measures to evaluate these areas. We recommend the following:
- IQ: Wechsler intelligence scales (WPPSI-IV for preschool/kindergarten, WISC-V for children and teens, or WAIS-IV for late-teen and adults).
- Academic achievement: Wechsler Individual Achievement Test, Third Edition (WIAT-III).
3. Screeners are insufficient for assessing learning problems.
Screeners are behavioral checklists and/or abbreviated versions of “gold standard” measures, and there are several reasons why they are inadequate for evaluating complex learning problems. First, they are not generally accepted by schools as evidence of diagnoses or need for classroom accommodations. Second, while they may be cost effective and a good first step towards identifying possible learning challenges, when used in isolation they do not allow conclusive or differential diagnosing (i.e., teasing out other possible causes). Third, they do not support identification of strengths. Fourth, screeners can deliver false positives/negatives for children with significant weakness, advanced abilities, or both (i.e., twice-exceptional learners). Fifth, unlike “gold standard” measures used by psychologists, screeners can and often are used by professionals with a wide variety of credentials and experience.
4. Insurance does not cover learning assessments.
Learning assessments are classified as “educational” rather than “medical” services. As such, health insurance policies will not pay for them. However, policies may cover testing that is provided by a psychologist or physician and results in a diagnosis for specific clinical disorder (e.g., ADHD or anxiety). The best way to find out what your policy will cover is to call the insurance company and ask. A psychologist can provide you with detailed invoices (that include clinical billing codes) that you can submit for possible reimbursement.
5. Learning assessments should evaluate strengths – and not just “problems.”
A quality learning assessment should provide insights and guidance that help scaffold a child’s overall happiness and success – not only in school, but across life. The process should include a survey of strengths, preferences, learning styles, interests, and temperament – all of which impact learning, self-concept, personal relationships, and career choices.
What is the first step you should take?
Some psychologists offer initial consultations for new assessment clients. During this meeting, they will gather history, ask about your goals for testing, review previous testing or other relevant records, describe their philosophy about assessment, outline the process, explain costs, and discuss other options. Essentially, clients should leave this session with a clear “road map” of what to do next, and what to expect along the way. The psychologist should then be able to connect with your child’s school to ensure that the testing they provide is what the school needs.
Above all else, never stop asking questions until you feel confident you’ve chosen the right path for you and your child.
– Dr. Katen
“Live the life you were meant to live!”
©2016 Individual Matters. All rights reserved. Permission is granted to share this article with others, as well as to print or post it on other websites, so long as credit is given to the author.
A Look at the Different Types of Learning Evaluations
There are many different types of testing available for learning-related issues.
Where and why you seek testing for your child (or yourself) will determine who evaluates your child, which tests are administered, how results are interpreted and communicated to you, what findings and recommendations follow, and the total amount of time and costs involved in the process. Discussed below are a few different types of testing, as well as related factors parents should consider when choosing the most appropriate option for their children.
Why are you seeking an assessment?
Answering this question is the first and most important step in the assessment process. What are your desired outcomes for testing? Are you hoping to understand your child’s gifts? Would you like to help your child understand his or her temperament? Are concerned about your child’s academic performance? Do you think your child may have a learning or attention disorder? Are you uneasy about your child’s emotional, social, or behavioral functioning? Has your school or pediatrician recommended testing?
There are all sorts of reasons that parents consider having their children tested. By outlining your goals, you will have a clearer idea about what type of testing is most appropriate for your child.
Who should conduct a learning assessment?
There is not a simple answer to this question. Many types of professionals administer “learning assessments,” but they often have dissimilar qualifications. To complicate the matter, professional credentials and licensure vary by state. For that matter, so do the ways that schools classify learning issues.
Regardless where you live, a licensed clinical psychologist (Ph.D. or Psy.D.) has the prerequisite education and licensure for conducting psychological testing and issuing clinical diagnoses. But not all psychologists specialize in testing – some only provide therapy, while others assess mental health rather than educational performance or neuropsychological functioning. Any professional – psychologist or not – who provides psychoeducational testing should have not only the minimal licensure and credentials, but also specialized training and experience in assessment.
Typically, schools and colleges will only accept diagnoses and recommendations from an evaluation provided by a doctoral-level psychologist. Furthermore, these institutions require “gold standard” instruments – standardized tests produced by reputable companies and backed by years of scientific research.
What type of learning assessment will you need?
Depending on your goals, there are a variety of assessment options:
Comprehensive psychoeducational assessment
This is a wide-ranging yet in-depth approach to understanding your child as a “whole person.” Comprehensive psychoeducational assessment evaluates neurological processes and cognitive functioning (IQ, attention, memory, processing speed, executive function, etc.), as well as academic achievement (skills in math, reading, and writing). Furthermore, the process will assess visual-motor integration, sensory processing, social and emotional functioning, visual and auditory processing, behavior, temperament and personality, gifts and strengths, learning styles, overexcitabilities, interests, life experience, and neurodevelopmental disorders. A skilled evaluator will be adept not only at administering the actual tests, but also at analyzing and integrating the results (including both quantitative and qualitative data). Essentially, this process should produce a manual that explains your child’s overall “operating system.” Since it evaluates multiple facets of your child – and not just learning issues – this process also supports conclusive diagnosis, generates specific recommendations, and guides the referral process.
Learning disability (dyslexia) testing
This type of assessment is recommended for the purpose of evaluating and diagnosing a suspected learning disability. In these cases, a qualified professional is someone who holds appropriate licensure and can issue a correct and pertinent diagnosis. The learning assessment will measure and compare a child’s IQ with his or her academic achievement – the traditional method for identifying a learning disability. If indicated, diagnosis of a specific learning disorder by a clinical psychologist qualifies a child to be considered for learning accommodations at school. While a “learning specialist” might test for dyslexia, it is important to understand that “dyslexia” is not a clinical diagnosis (per the DSM-V). By itself, identification of dyslexia may not be sufficient to qualify your child for special services at school. Furthermore, limited assessments such as these may not reveal or conclusively rule out other causes of learning problems – in fact, sometimes they produce more questions than they answer.
Attention-Deficity/Hyperactive Disorder (ADHD) is a complex neurodevelopmental disorder (not a learning disorder). Who can diagnose ADHD? Generally speaking, only a medical doctor (M.D.), psychiatrist (M.D.), or psychologist (Ph.D. or Psy.D.). In most cases, diagnosis is based solely upon results of behavioral checklists and interview with the child and parents. However, there are many reasons for a more in-depth evaluation. As a result, some psychologists assess ADHD using not just checklists and interviews – but also neuropsychological measures of IQ, attention, memory, and executive function. Unfortunately, there is no single, decisive test for identifying ADHD.
What are the costs of a learning assessment?
Just as the types and scopes of testing vary, so do the costs. Some learning professionals and tutors provide “learning assessments” for as little as $300 or $400. These can be completed in a few hours and may (or may not) utilize standardized tests of IQ or achievement, result in diagnoses, or provide individualized recommendations. Unless completed by a doctoral-level clinical psychologist, these evaluations may not qualify a student for accommodations at school.
Evaluations conducted by schools may be more extensive, but schools do not diagnose learning disorders or ADHD. Schools may assess for learning “issues” like dyslexia and make recommendations for special education services, but only psychologists and doctors diagnose clinical or medical disorders. Furthermore, school evaluations are not intended to assess your child as a “whole person” – only whether he or she has a condition that affects functioning in the classroom. Since educational classifications and resultant accommodations are based upon your child’s current grade-level and classroom functioning, they may not be pertinent a year from now.
Finally, comprehensive psychoeducational assessments are conducted by doctoral-level clinical psychologists. Prices typically range from $1500 to $5000. The entire process involves 8-15 hours of testing, twenty or more hours of scoring and analysis, an extensive and detailed written report (15-25 pages), a feedback session with parents, and school consultation. Clinical diagnosis of a learning disorder by a psychologist who utilizes “gold standard” test instruments is often required by schools before they will consider a student for school-based learning services and supports. Furthermore, a high quality assessment will accurately capture your child’s gifts, strengths, personality, and underlying areas of challenge (the “whole person”) – and stay relevant for years to come.
Want more information?
As a parent, you justifiably want to ensure that whoever evaluates your child can deliver outcomes that support your specific goals for testing. How do you do this?
One way to find out is simply to call their offices and inquire. Some will provide basic information over the phone.
Another option is to schedule an initial consultation. During this meeting, you can ask the assessment professional about his or her background and scope of expertise. Also, find out what specific tests they use, whether they issue clinical diagnoses (as contained in the DSM-V), and if their findings can and will be accepted by your child’s school. You might also inquire about their overall philosophy towards assessment, learning, and ADHD – in other words, how they approach testing, and why. While psychologists are unlikely to share client testimonials (due to patient privacy policies), they might offer generic samples of past reports. Furthermore, consultation with an experienced assessment psychologist sometimes results in immediate referrals that save you time and money. In any case, this initial step will give you solid information – a “road map” for action – that helps you to be more informed about, and comfortable with, the testing process.
– Dr. Katen
“Live the life you were meant to live!”
©2016 Individual Matters. All rights reserved. Permission is granted to share this article with others, as well as to print or post it on other websites, so long as credit is given to the author.
How to Pay for Learning Assessments?
To use insurance or to private-pay? That is the question, right? Perhaps you’ve already decided to go forward with a psychoeducational (or learning) assessment for your child or yourself. Or maybe you’re still busy comparing services, costs, and trying to determine whether and how to pay for the assessment. No doubt you’ve spent a lot of time researching options. You understandably want to find the best possible assessment service – but also at the most reasonable cost!
Somewhere during your research, you’ve probably wondered whether to pay for the psychoeducational assessment with insurance or private-pay (i.e., paying with cash, check, or credit card). What are the advantages of each payment option? And which is right for you and your family?
Both options – insurance and private-pay – have their advantages:
- Can reduce the cost burden. Depending on your insurance plan, as well as the type of assessments and diagnosis, insurance companies may pay for some or all of the costs of testing for “medical” conditions (usually these refer to mental health or neuropsychological issues that are deemed “medically necessary”).
- Discounts are typically available for going through “in-network” providers.
- Other discounts may be available when you use “out-of-network” providers.
- Insurance does not pay for “learning” or “educational” assessments. Insurance policies do not typically cover “learning” or “educational” assessments such as testing for learning disabilities. In general, insurance does not pay for psychoeducational assessments of academic achievement, cognitive (IQ) testing, or personality and temperament inventories. However, as discussed above, your health insurance might cover assessments of certain “medical” conditions. For example, depending on your insurance policy, you might be reimbursed for assessment of mental health issues or, in some cases, ADHD. Your policy might also pay for certain types of neuropsychological testing that your physician believes to be a “medical necessity.”
- In order for insurance to pay, you must be diagnosed. This is important to consider before you decide to utilize insurance. Since health insurance is part of the medical model, you (or your child) must be diagnosed with a mental health condition if you utilize insurance. This stipulation is important to understand up front, since any subsequent diagnosis will become part of your permanent medical record – possibly affecting your future insurance coverage, school options, employment, etc.
- Your privacy is protected. When you pay privately, you share an agreement with your psychologist – and no one else. With the exception of special cases (e.g., issuance of a court order, or in situations where someone’s life or safety is threatened), your records will never be released without your written authorization. Cash sessions are entirely confidential. Conversely, insurance companies can and do audit psychologists – meaning your (or your child’s) records must be made available to the insurance company and, quite possibly, various other “third party entities” (such as government agencies). Even if your psychologist is not audited, he/she is still required to submit certain information about you to your insurance company (see below).
- Only you and your psychologist determine scope of care. When you pay privately, your psychologist will work with you to formulate goals and intervention based upon your unique circumstances. These plans can be modified, continued, or concluded based on the decisions you make together – in confidence. On the other hand, insurance companies require psychologists to submit client treatment plans – which their claims departments will then decide to approve or deny. When you choose to utilize insurance, the type of assessment, results and diagnoses, and recommended treatment must be submitted to your insurance company. Their claims department will then determine whether the outcomes and recommendations of your sessions fit the insurance company’s decision-making matrix.
- You have more options. When you pay privately for an assessment, your psychologist can utilize any assessment tools that he/she believes will be most helpful and appropriate for yielding a clear and comprehensive profile. He/she is not constrained by what your insurance company will or will not pay for.
- No hidden costs. Private-pay typically involves “flat fee” rates. For example, if an assessment is advertised as $800, then that’s the final cost. All agreed upon services will be provided for that price. There are no “extra” or “hidden” costs. You will not receive any “surprise” follow-up bills.
- Often less expensive than insurance. In the long run, the cost of a psychoeducational assessment may end up being less when you private-pay. One reason is “deductibles.” Insurance companies typically require you to pay a certain amount before they will cover additional costs. If this amount (i.e., your deductible) is greater than the cost of the evaluation, your insurance policy will not pay. Keep in mind that, just because you have received an initial quote for reimbursement, this does guarantee you will actually be reimbursed (as mentioned above, claims may still be denied). Furthermore, since insurance companies direct scope of care, they may agree to cover only a limited-scope assessment. And in all cases, the insurance company will require a diagnosis. But what if no diagnosis is warranted? And what if further testing is appropriate? When all is said and done, you may be left with more questions than answers, and the total cost of the assessment process will increase substantially.
- You pick your provider. Perhaps most importantly, when you pay privately you are able to choose your provider based on “best fit” for you (and your child).
What should you do?
There is no single, best, “right” way to pay for a psychoeducational assessment. Both insurance and private-pay have their advantages. Here are a few final suggestions to consider:
- If you have insurance coverage, check your particular plan by calling the customer service number on your card. Ask the representative about the benefits of using in-network and out-of-network providers, as well as to explain exactly what is (and is not) covered by your plan.
- If you have a Health Savings Plan, you may be able to use these funds to pay for psychoeducational assessment. Check with your HSA provider.
- If you can afford to do so, use cash or check to pay for psychoeducational assessment. This ensures the highest levels of privacy and comprehensive service options.
- If you need to use insurance, get a quote from your company, pay privately first, and then seek reimbursement. Your psychologist can issue you a detailed invoice with insurance billing codes. However, keep in mind that, if you do utilize insurance, your psychologist will still be required to issue a diagnosis (and then submit it to the insurance company). But with this option, you can at least have greater freedom in your choice of psychologists.
- If you still have questions or are uncertain about the options, call and ask your psychologist. They love helping individuals and families – and they will be more than happy to provide information or answer any questions you have!
– Dr. Katen