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Ask the Doctor:

Psychological Disorders and Psychological Screening Tests

What are the recommended psychological screening tests and evaluations for the newly adopted post-institutionalized children?

Fortunately, there is a growing appreciation of the unique needs of adoptive children. While efforts are made to evaluate and understand the medical background and medical status of adoptive children, little attention is given to address the emotional and behavioral needs of these children. This is particularly important, in light of the fact that a significant number of adoptive children have been exposed to traumatic events. The following information is provided to assist adoptive parents in knowing the kinds of test and evaluations that can be utilized to assess newly adopted, post institutionalized children.

Members of the mental health community (e.g., psychiatrists, psychologists, social workers and counselors) have their respective areas of expertise. One of these professionals, however, focuses on the administration and interpretation of psychological tests—the clinical psychologist. Psychological assessment data provides important information regarding a child’s abilities, as well as his/her personality and behavioral functioning. It is important to recognize that standardized test batteries that are administered by school psychologists focus on the academic needs of children for special school placement. These evaluations do not necessarily address the unique needs of newly adopted post institutionalized children. For example, developmental and historical data must be a primary focus when evaluating adopted children. These areas will be of less importance to a school psychologist who is trying to identify a student’s areas of academic strength and weakness.

As children become older (e.g., over six years of age), the reliability and validity of psychological assessment measures increases. However, as adoptive children become older, the likelihood of exposure to physical and sexual abuse or neglect of basic needs, concomitant with various degrees of abandonment, becomes greater. These variables may contribute to the development of significant emotional and behavioral problems that warrant psychological evaluation and perhaps, intervention.

When evaluating adopted children, there is no standardized battery of tests. The choice of assessment measures should be made by the clinical psychologist and may vary depending upon the specific reason for referral (e.g., parental request, court ordered evaluation, school evaluation, etc.). Notwithstanding, evaluations with post institutionalized children should include assessment of the child’s developmental history, familial history (i.e., when available), social history (i.e., including, but not limited to the evaluation of traumatic exposure), educational history and academic achievement (i.e., for school-aged children), cognitive abilities, perceptual-motor abilities, and the child’s emotional and behavioral functioning. The utilization of neuropsychological measures may be helpful when there are concerns regarding the potential of organicity. Similarly, language assessment may be helpful when there are concerns regarding the presence of receptive or expressive language-based problems.

As indicated previously, attention is being given to understanding the medical background and medical needs of adoptive children. In the same way, attention must be given to understanding the psychosocial needs of these children. A clinical psychologist, experienced in evaluating adopted children, can be an invaluable resource in reviewing documentation and in assessing the unique needs of the post institutionalized adopted child.

by Mark Lerner, Ph.D.


The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it - only after a careful history and physical exam can a medical diagnosis and/or treatment plan be made. This Web site does not constitute a physician-patient relationship.

This material has been provided by AdoptionDoctors.com, an innovative adoption medicine private practice and educational service, dedicated to helping parents and adoption agencies with the complex pre-adoption medical issues of internationally adopted children. All medical interactions are performed via, e-mail, express mail, telephone, and fax. There is no need to make a live appointment or travel outside of your hometown. For more information, visit AdoptionDoctors.com or call 631-499-4114.

© Mark Lerner, Ph.D.

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