A Parent’s Guide to Cognitive Assessment

Stella Franzese, Psychologist

We can all agree that the ‘school world’ children live in today is completely different to ours ‘back in the day’. There are notable differences in the subjects studied, classroom layout (assigned desks vs flexible learning spaces), interests (outdoor cricket vs Minecraft), jargon used (“the bomb” vs “lit”), technology available and teaching methods provided to students (blackboards and paper vs interactive whiteboards and iPads). Consistent with these changes, there has been a shift in the way we think about and assess children’s progress, thinking and learning in school settings.

Imagine that you have a son named ‘Johnny’ in Grade One. He is a vivacious and affectionate boy who loves sports and enjoys going to school. His teacher has completed her usual assessments to determine Johnny’s progress in fundamental subjects (reading, writing and maths). From Johnny’s previous school reports, you’re concerned that he’s performing below standard and don’t want him to fall behind further. One day, Johnny’s teacher and Assistant Principal sit you down and ask you to sign a consent form as they believe that given Johnny’s difficulties he may benefit from a Cognitive assessment and/or Oral Language assessment. At this point you’re thinking, my son would benefit from what? Why? How is this going to help him?

The ‘What’. What are they talking about? ​

First off, let’s define cognition.
Cognition is our mental process of not only acquiring information, but making sense of it. ​

Do these assessments have a name or is it just ‘cognitive assessment’? ​

The most commonly used cognitive assessments in Victorian schools are:

• Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV) for children aged 2.6 to 7.7
• Wechsler Intelligence Scale for Children (WISC-V) for children aged 6.0 to 16.11

For children in Years 11 and 12 there is the Wechsler Adult Intelligence Scale (WAIS-IV) for individuals aged 16.0 to 90 years 11 months. However, it is rare that cognitive assessments at this age are administered for educational purposes.

Cognitive assessments (or intelligence tests/IQ tests) are used in school settings to assess a child’s level of overall cognitive (aka mental) ability, learning capacity and identify their cognitive strengths and weaknesses (for example, does your child thrive with visual information? Are they good at problem solving? Do they better deal with verbal information?).

What do these assessments measure?

These assessments measure cognitive abilities within 5 primary indexes, or ‘areas’ of intelligence:

• Verbal Comprehension: A child’s ability to not only understand verbal information, but use their own long term knowledge and vocabulary to accurately express themselves.
• Visual Spatial: A child’s visual/spatial/non-verbal reasoning abilities.
• Fluid Reasoning: A child’s ability to think flexibly to solve a new problem using problem solving, planning and their own skillset. The ability to detect underlying relationships between concepts and ‘rules’ in a task to solve this novel problem (aka, can they pick up on what the pattern/ rule is and what strategies they need to tackle a novel visual/abstract problem?). It involves seeing the “bigger picture”, figuring out how things relate to each other and how everything works.
• Working Memory: a child’s ability to pay attention, take in multiple bits of information, mentally work with it and hold onto it long enough to produce an outcome (the best example of this is trying to memorise the digits of a phone number by repeating them over in your mind until you can write it down).
• Processing Speed: A child’s speed and accuracy of visual scanning, mental processing, motor coordination and visual decision making.
• The Full Scale IQ: Your child’s IQ score and overall estimate of their cognitive abilities based on their performance across the indexes.

There are many other ‘ancillary’ or ‘other’ indexes that can also be calculated, however it’s not a ‘need to know’ for now. If relevant to your child’s case the Psychologist can explain it to you.

The assessment within a whole process

The cognitive assessment itself is actually NOT the only thing Psychologists do when they conduct a cognitive assessment. Here is a brief dot point summary of the process:

• Parent Consultation: To gather developmental history, to gather information about the child’s current functioning, build relationships with the parents and gain an understanding of parent concerns/specific requests of the parents.
• School Consultation: To gather history of difficulties, gain a thorough understanding of the child’s academic functioning.
• Behavioural Observation: To see the child ‘in action’. How do they respond to task instructions? Can they keep up with the demands of the class? Do they experience difficulty in one subject? How do they socialise with other kids? How does the child’s quality of work compare to their peers?
• Cognitive Assessment Behavioural Observations: Here we observe and take note of your child’s behaviour during the assessment itself. For example, do they make sufficient eye contact? Do they use concrete language? Can they participate in an interactive conversation? How do they describe school/home life? Can they respond to instructions? Can they pay sufficient attention to meet the assessment demands? How do they tackle tasks? How do they self-soothe when they find a task challenging? Can they be encouraged if they are overwhelmed? Are the child’s results impacted because the child is unmotivated or tired? < These observations are invaluable and are a part of the reason why I have managed to make quality recommendations to schools.>
• Cognitive Assessment: Involves non-academic, interactive activities (particularly for the younger children). The Psychologist and child build rapport and most commonly complete 10 subtests (or presented as “fun activities” to the child).
• Feedback Session with the parents: Meeting with the child’s parents/school to discuss the results and what it means for the child.

Now, depending on the unique situation of your child, there may be other things that occur alongside this ‘standard process’. For example, if you’re looking to obtain funding through the school system for Intellectual Disability, a Psychologist would have to complete other assessments AS WELL as this and write a separate funding report.

Cognitive assessment, part of a formula

It is quite often that the entire cognitive assessment process (from parent consult onwards) is paired with other standardised assessment for different referral questions. Here is a brief snapshot.

Intellectual Disability: Cognitive Assessment + Adaptive Functioning Assessment
Language Disorder: Cognitive Assessment + Language Assessment 
Specific Learning Disorder: Cognitive Assessment + Achievement Assessment (sometimes memory assessment and phonological awareness testing is also included)
Giftedness: Cognitive Assessment ​+ Gifted Rating Scales or other information gathering

The ‘does this ring a bell?’ game

A good way to understand the abilities that cognitive assessments measure is to know what the “strengths and weaknesses” in these skills actually look like in school aged children. Have a look at this table and see if any of these ‘ring a bell’ or ‘ring true’ to your child.

Now that we understand what it measures, how do I make sense of these results?

A lot of scores come out of cognitive assessments, however I feel that parents should be knowledgeable of two things:

​Percentile Ranks
Percentile ranks reflects how a child performed compared to children the same age. Let’s say we lined up 100 boys the same age as Johnny in order of ‘ability. The little boy sitting at position 1 would be the worst performing and 100 the best. If I told you that Johnny was sitting at the 50th percentile, it means that he is RIGHT in the middle and performing as he should be for his age OR that he is performing better than 50% of children his age. With cognitive assessments, the Average Range falls within the 25th to the 75th percentile.

Standard Scores
Put simply, standard scores are these converted scores that Psychologists use to determine where Johnny’s cognitive abilities lie in comparison to other children his age and what range of ability he falls under. You’ll see ranges associated with standard scores for the indexes and Full-Scale IQ. As an example, any standard score between 90 and 109 falls within the Average Range.
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Here is a general scoring guideline table for quick reference:

What do schools do with cognitive assessment results?

Psychologists make recommendations that teachers can use to develop a personalised learning plan for the child. These recommendations are made based on your child’s strengths and weaknesses. As a very simple example, Johnny might have a personal strength with visual-spatial skills but weaknesses in working memory.

The psychologist might then recommend that all instructions provided to Johnny in the classroom be concise, clear and provided to him one at a time. The psychologist might also recommend that instructions or demonstrations in the classroom be highly visual in nature when being delivered to him or that verbal instructions are paired with visual stimuli.
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Depending on the reason for the referral, these results and the report might be passed onto a paediatrician or submitted as evidence for a funding application within the Victorian school system.

The cognitive assessment process is a highly rewarding one. It provides educators and parents with the opportunity to better understand the learning needs of the child involved, and also to address your concerns as parents about why they are falling behind academically.

At Hopscotch and Harmony, we have a team of Psychologists including myself who are highly experienced in conducting cognitive assessments and thoroughly enjoy collaborating with parents and educators to achieve the best outcomes for children.
To make an appointment, please don’t hesitate to ring the Werribee Clinic on (03) 9741 5222.
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I have developed a “Guide to cognitive assessment: A cheat sheet” as a resource for schools and parents. This provides a brief snapshot of the contents in this blog post. I hope you find it useful!

Stella Franzese is a Hopscotch & Harmony Psychologist who is particularly passionate about working with children with Autism Spectrum Disorder, Attention-Deficit Hyperactivity Disorder and children with academic difficulties. Her love for working with children is fuelled by her belief that quality early intervention significantly improves a child’s functioning and sets children up for their future.