Child psychologist Olivia Moorehead-Slaughter, PhD, has guided a lot of parents through the years as they’ve considered whether a test or an evaluation might assist their child’s learning trajectory.
Moorehead-Slaughter listens closely to better discern parents’ reasons for seeking testing, as well as what they have already observed about their child’s learning behaviors. Most parents, she finds, simply want to do whatever they can to help their children learn or improve their ability to succeed in school. But there have been rare occasions when she’ll sense that a parent wants a specific outcome, whether that’s gaining admission to a particular school or getting a diagnosis that gives the child a competitive boost, such as more time to take a standardized test.
For instance, a red flag would be if there is an almost singular focus on “How do you get this accommodation or that accommodation?” says Moorehead-Slaughter, who works at a private school near Boston and is on the faculty at the Center for Multicultural Training in Psychology, affiliated with Boston Medical Center and the Boston University School of Medicine. Another potential red flag, she says, is if a parent’s sights seem overly focused “on a particular institution or a tier of institution and what they understand is necessary to gain access.”
The 2019 college admissions scandal, in which some parents reportedly pursued accommodations for their childrenopens in new window to provide cover for cheating on college admissions tests, provided an extreme illustration of this problem. But psychologists may also encounter more subtle scenarios in which parents place pressure, even unconsciously and with good intentions, during the assessment process. Along with pursuing a finding or a diagnosis that parents think will benefit their child’s educational path, these circumstances may arise in other settings, such as childcustody evaluations.
A common thread that runs through many of these scenarios is that “there’s an urgent need for information that could unlock resources for people,” says Rebecca Schwartz-Mette, PhD, an assistant professor of psychology at the University of Maine and chair of APA’s Ethics Committee.
In some cases, assessments can end in shades of gray. A child may demonstrate some traits of an anxiety disorder or attention-deficit hyperactivity disorder (ADHD) but not to the level to meet diagnostic criteria, Schwartz-Mette says. That can frustrate parents who feel their child still needs more educational help, she says. They also may have footed the assessment bill, depending upon their insurance coverage, and anticipated getting answers that would provide a clear path forward, she says.
“I very rarely experience a family who is pressuring a psychologist,” Schwartz-Mette says. “I think that the family feels the pressure of finding an answer, and then they’re really pinning their hopes on the psychologist that they can provide that answer.”
Establishing expectations
To help avoid later problems, it’s vital for psychologists to make sure parents understand up front how the evaluation process works, says Heather Loffredo, PsyD, director of testing at Alvord, Baker & Associates in Rockville, Maryland. Before Loffredo evaluates a child, she explains to the parents that the psychologist’s role is to look “at where the data converges, and not just one specific data point.”
She also delves into parents’ goals and expectations, asking them directly: “What are you hoping to get out of this assessment?” And she watches out for clues to underlying motivations. For instance, parents may describe how they want insights into their child’s learning style and why they struggle with school, Loffredo says. That’s quite different from a parent who tells a psychologist, “We’re really thinking that our kid has ADHD, but the school won’t give resources without data to back that up.”
In the latter example, Loffredo will devote additional time to explaining that even if an evaluation does not yield a diagnosis, it is valuable to uncover insights about a child’s learning strengths and weaknesses.
Leslie Drozd, PhD, a California-based clinical and forensic psychologist who performs child-custody evaluations, also clarifies her role from the start. Depending upon the case, she may be hired by an attorney representing one of the parents or she may be appointed by the court as a neutral evaluator.
If she’s been appointed as a court evaluator, Drozd alerts the parents involved that what they tell her will not be confidential. She wants them to consider the potential ramifications of the information they share, such as any personal risk if one parent alleges abuse by the other. “I make it clear on the front end that I can’t be told something that I’m not going to check out with the other parent,” she says.
A psychologist makes recommendations to the parents and ultimately to the court as to what is in the child’s best interest, such as how much time each parent can spend with the child, Drozd says. In this emotional and complex process, even highly experienced psychologists can face extreme pressure, she says—for example, in a situation in which one parent is alleging abuse and the other parent is denying those accusations and asserting that they are false and designed to cut them off from their child, she says.
If Drozd questions whether she is being unduly influenced toward an outcome—such as who will be the primary caregiver—she will consult with another psychologist, summarizing the case broadly without identifying details. Or, if the parents sign releases, she may share some specifics, including part of the data.
That ensures that she maintains the ability to see things from various perspectives, Drozd says. “With the intensity of the emotions that can occur in these cases, there are blind spots that any of us can have.”
Handling disappointment
Sometimes even when she sets up expectations in advance, Loffredo finds herself managing dashed hopes when she reviews her findings with parents.
In some cases, the child’s scores on IQ or other academic tests might not be high enough for admission to a school or program that the parents had in mind, she says. Or perhaps parents want their teenager to be reevaluated for an existing learning disorder before starting college so they can get accommodations there, but a new evaluation shows that he or she no longer meets criteria for accommodations for the disability.
“When I see frustration around things like that, it’s usually because the parents are very anxious about how their child will perform in college,” says Loffredo, who strives to address those worries. She’ll remind parents that colleges and professors are often open to more informal accommodations. Plus, there are other ways parents can help their child succeed, such as setting up supports at college.
Psychologists themselves may also struggle when the findings prove inconclusive or not what was initially anticipated or desired, Schwartz-Mette says, particularly when a lack of a diagnosis means a child does not qualify for services that may still be beneficial.
“That’s when we have to just breathe and say, ‘We did what we could,’” Schwartz-Mette says. “But [we cannot] stretch results or let that feeling of wanting to help push us in a direction where our judgments and our conclusions are not based on our scientific and professional observations.”
Moorehead-Slaughter agrees. “Psychologists, at their core, just want to be helpful,” she says. Sometimes this desire to help, she says, can land people in uncomfortable territory.
Occasionally, Moorehead-Slaughter has gone so far as to not refer a parent to a colleague if she perceives that the parent is less interested in fostering their child’s learning than unduly situating them at a competitive advantage. “I am not going to move to the step of facilitating a process that I think is not one that is appropriate, that I think may actually be harmful or a misuse of assessment,” Moorehead-Slaughter says.
