Why Test?

Imagine that you have a child, or a student in your classroom or in your life, and something suggests this child has a low IQ. I've worked with children who appear not to understand what people say, who are very forgetful, or who don't appear to be learning to read. Sometimes, parents and teachers just say that they have "strange ways" or something else that they can't really describe. When I talk to their parents, one of the things that has struck me is that the parents have usually already done a little testing whether they realize it or not.

If we imagine a child who appears very forgetful, and he or she must be forgetful to the point that there is a real question about succeeding in school, then most parents investigate. They might ask children whether they remember things that happened to them, or to recall and tell them about what happened in TV shows. In other words, they take a little sample of behavior that can demonstrate intelligence or memory, and they observe whether their child can do it. Other parents are never this formal, but just try to observe and recall little bits of behavior and make conclusions from these. When a teacher says that she's worried because little Abby didn't remember the state capitals she just learned, a parent might reply that everything is fine because little Abby does remember the street where grandma lives. In order that we have something to call it as we compare it to other approaches, let's give this kind of testing a name. After a chat with my mother, I'm going to go with "The Parent Administered Test of Smarts" or "PATS" for short. This kind of informal assessment is fine most of the time, especially since most children are typical and most worries from parents and teachers sort themselves out. However, PATS is not enough for a more serious evaluation that can have significant consequences for someone's future.

The first shortfall of the PATS is that there is no way to compare the results to other kids. Years ago, I lived with a roommate, a dog and a snake. On the Fourth of July one year, my dog did as dogs will do when fireworks started going off and he ran under the table in a panic, hoping to curl into the smallest ball he could. My roommate asked if the dog would be OK, and then (and this was very kind of him) also checked about the snake. He asked if he might also be worried by the noise and if we should open his cage and check on him. I was surprised and replied, "snakes are deaf." I know it's mean, but I was shocked that he could be so dumb. Then of course, I told the story to other people (gossiping is bad, I know) and it turned out that I was the dumb one. Lots of people don't know snakes are deaf (it goes with the territory of most people never having taken care of a snake or being interested in them) so when I would tell people about this thinking that it was a funny story about how my roommate could not have known such a simple fact, everyone just said "oh, I never knew snakes were deaf." I was mistaken because I didn't have a good impression of what people know. This is a normative sample. When an IQ test is made, it's given to hundreds or thousands of kids at different ages so that we can actually say with confidence what percentage of kids at what age can answer what questions and solve what problems. Without this step, PATS testing a child can't really get at whether the questions we ask are something that most kids that age will know, or are too hard or too easy. Even after testing a lot of kids, I still always need to check what is expected at what age. Being sure what to ask or how hard something should be is a very difficult thing and not something to be estimated when it's important to get it right. Once we figure out exactly what to ask at what age, there's also the problem of exactly how to ask it.

It is incredibly difficult to really test a child. If you ever get the chance to sit in a classroom or watch a child and parent interact, a positive interaction will usually have a lot of give and take and lot of teaching. The last time I bought groceries, I saw a mother point to the peaches and ask her daughter (who looked younger than five) if she knew what they were. Her daughter at first said "apples" and so the mother did what good parents do and went through asking her what colors apples were, reminding her of times they'd eaten peaches and otherwise gently reminding her daughter that these were peaches, until her daughter very happily yelled "peaches!" That's wonderful, adorable and a completely appropriate way to interact with a child. It's hard not to want to help when a child doesn't know the answer to a question. It's also hard to know how to ask a question in a way that won't influence whether or not a child with know the answer. When a parent looks back on the PATS testing they've done, there is no reason to expect that he or she has asked a question without a hint, or without giving a little support (it really is an unusual way to talk to a child). I've also observed that parents and teachers will give this little bit of help, or will accept a lot of answers that are maybe a little off and when I talk to them about it, they generally just remember the interaction as "I asked the question and the child answered." This is why it's such a hard skill to administer an IQ test. Training involves how you interact and the tests themselves give very, very specific ways to ask questions, to describe tasks and (when you are allowed to help) the help you can give. Some are as detailed as having you say something like "what do you call this piece of clothing?" which is very different from "what do you call this thing?" or "what do you call this kind of shirt?" Without this level of structure, there is no reliable way to know what exactly you asked.

There is another problem with PATS testing that is one that psychologists have had to work very hard to address. Thankfully we can explore this one with waffles (I love waffles, so I had to include this example). Dr. Jim Laidler was an early proponent of untested Autism treatments such as gluten free diets and chelation (a treatment for heavy metal poisoning). To be clear, Dr. Laidler is a very smart guy (he's an anesthesiologist, and has published in high level academic journals). He also has two sons with Autism Spectrum Disorders. He had both on strict diets and schedules of supplements and kept careful notes of their progress and response to them. Then one day, on a trip to Disney World, the family went to a buffet. Dr. Laidler and his wife brought boxes of special food for their sons, but in a moment away from his parents at a buffet, one of Dr. Laidler's sons ate a waffle. Dr. Lailder has written several places about how he expected to see an awful outcome from his son eating a big pile of sugar and gluten, but nothing happened. I think his wife may have been less surprised because it turned out that she'd been taking the boys off of all of their supplements and untested treatments anyway. Slowly, Dr. Laidler realized that he had been doing careful observations of effects that weren't really there (http://articles.latimes.com/2009/dec/07/health/la-he-autism-parents7-2009dec07). It's just that hard to really carefully record someone's behavior (no matter how many degrees you have). If you aren't incredibly careful and systematic about recording behavior, or if you're motivated to see a particular outcome, you can miss a lot. A test is a sample and not a whole day, but it's one of the very few ways to get a reasonably objective record of behavior. Each test is administered with a "Protocol," which is a form on which every response of a child is recorded and noted. Without it, I can't imagine trying to write out or remember every response. It'd be too easy to remember "oh, he got three of those right" and not think about the four he got wrong. Alternatively, I've been surprised when children who were sluggish, quiet or had teachers really worried, would slowly but surely get a lot of things right.  

A lot of people I meet are not thrilled with the notion of "tests." I think high stakes testing in schools has a lot to do with this, or just the idea that some people are bad at tests and there are certainly legitimate concerns there. At the same time, I have a lot of trouble imagining a convincing argument to abandon tests. If you ever want to know what someone else knows, what alternative is there to asking questions or challenging them to puzzles? What an IQ test does, is go about this systematically, with consistent tasks and fair comparisons to a large sample of other people. It's not magic or a secret knowledge some of us have, but it's an acknowledgement of how hard it is to figure people out.

What is a School Psychologist?

We are the professionals most responsible for determining who needs Special Education Supports and what kind. That's the shortest answer and if it works for you then, I won't be offended if you stop reading right now. It's also interesting to learn about how we do this, though. 

One important thing to keep in mind is that we are part of a team. We take reports from teachers including class work, grades, their observations and formal measures such as ratings scales on which teachers report behavior and their responses are compared to a large sample of such reports. We do the same with parents and with other professionals (Speech and Language Pathologists, School Nurses, Physicians etc) who have worked with the child. 

All of the reports and our observations and interactions with the child then form a big part of the picture of why a child might be having difficulty in school and help us interpret tests that we give. Testing includes Intelligence (including sub-abilities like working memory and reasoning) achievement and sometimes other areas such as attention. These give us a feel for where a child is performing in all of these areas under what are basically the ideal conditions since they are administered one-on-one with us there to encourage the child and assure that they are doing their best, aren't distracted and get a lot of encouragement. 

Next, we put all of the information together and start to form a conclusion about why the child is struggling. For example, if little Timmy has had an uneventful upbringing, gets along well with teachers and peers and has typical intelligence (with maybe an area of weakness here or there) but he has great difficulty in reading, then it looks like he has a learning disability in reading. If little Julia can perform well on all of the testing with me, but she cries and refuses to do math in her classroom or with her parents, then maybe she's anxious about math. 

Finally, we work with parents and teachers to develop a plan for how to help the child. In Timmy's case, maybe we recommend reading help and the resources that are available in our schools (such as reading specialist or small group instruction). Until his reading catches up, (which it sometimes will and sometimes won't) we may look at resources such as software that reads his textbook to him out loud. Depending on the level of care needed, we and the rest of the staff working with the child will determine whether this rises to the level of a Disability that requires Specially Designed instruction (that is "Special Education").

It's also good to keep in mind that such a thorough evaluation is not always needed. If a child has low vision for example, Special Education may just be a matter of enlarging his or her reading and math materials. If a child only has difficulty with speech and communication, then an evaluation from a Speech and Language Pathologist may be the only thing required. Some schools also have significant "pre-referral" processes such as getting a child into extra math or reading help as soon as possible and carefully tracking his or her progress. In other words, that's our job generally, but the specifics always depend on the child and the school.   

Russell Wilson’s Magic Water

Concussions are a very big problem in football. A VERY big problem. At this point, I don’t think this is a controversial statement, but it’s still worth discussing because football is such a big part of so many people’s lives. I include myself in this. I worked for Temple’s football team in grad school (I tutored our guys, so nothing that exciting) and still follow the team, along with Penn State and the Eagles. All injuries are scary, as is just having a 300 pound man running at you at full speed, but brain injuries are terrifying. Tragedies like the suicide of Junior Seau are heartbreaking and are directly linked to brain injuries http://espn.go.com/espn/otl/story/_/id/8830344/study-junior-seau-brain-shows-chronic-brain-damage-found-other-nfl-football-players.

This all makes it too sad to laugh the Russell Wilson, the Quarterback for the Seattle Seahawks, suggested that magic water might have helped him avoid a concussion. http://www.seattletimes.com/sports/seahawks/russell-wilson-clarifies-concussionrecovery-water-comments/ As seen in Rolling Stone and the Seattle Times, Wilson appears to suggest (though he backed off a bit in the second interview in the link) that “Recovery Water” allowed him to come back from a blow to the head. “Recovery Water” is one of the roughly millions of products that makes vague claims that it will help you be a better athlete. The website does provide a "scientific study" to show that it improves performance. Oddly, the study does not look at what I think most people would consider recovery (bouncing back from an injury or exercise). Also, shockingly, the inventors of the product (which claims it uses vaguely defined “nanotechnology” to vaguely give you “healthy cells”) found a positive result, although even the tiny study they provide did not actually have statistically significant results. They were almost significant, but come on, I need a little more proof that your water actually has magic healing properties. The link to the study is here for your review, although I can’t find that it was every submitted for peer review http://recoverywater.com/wp-content/uploads/ACSM-2011-abstract_submitted.pdf.

If even one young football player thinks he can avoid or lessen his concussion with Wilson endorsed magic water, then he’s done that young man a horrible disservice. This isn’t an idle thought, either. Google “football pickle juice” for some fun shots of athletes drinking actual pickle juice as a way to hydrate (the best is this guy, who didn’t take the pickles out of the jar http://www.sbnation.com/lookit/2013/9/13/4728868/boise-state-jay-ajayi-pickle-juice). Trends like this can spread rapidly among athletes, especially when a top player on a top team is into them. If Russell Wilson says that he likes recovery water (for the taste, the subjective feeling or whatever) then I really don’t care. I’m not paying for it unless I get a darn good explanation about the nano-whatevers and at the very least a study of its effects not conducted by the people who are selling it. NFL players also don’t play that long (injuries can rack up fast) so I don’t blame him for taking the sponsorship deal. However, we all need to be very aware of the risks of suggesting an ineffective treatment for such a serious injury. Maybe a good rule would be to avoid any treatment that comes in “Essence of Cucumber and Mint” flavor.      

Why start a school psychology blog?

This is not a blog meant to help anyone do better on IQ tests. This blog is only to help you understand IQ tests (and similar tests) and what it means when you, your child or someone else takes one. There is also no separating IQ tests from Special Education, so I'll be writing a lot about that as well.  

There are two main reasons for me to take the time to write this. The first is to make my life easier as a school psychologist. Most people don't know what school psychologists do, but one of our most important functions is being on the team that determines a child's eligibility for Special Education. We are the ones who administer IQ tests professionally, and the ones who train for years to know what they are and what they mean. I am fortunate to work in a situation where I have the time to sit down with parents and students and explore their worries and explain what I have found. In some places, the School Psychologists are so over-worked that they have to send their reports off and hope that the parents and teacher who read them will understand them. I'm hoping that this can serve as a little bit of a "greatest hits" of the questions I usually have to answer for teachers and parents. I'd like to think maybe if you google a question you have about something I or my colleagues do, then I'll come up and we can save some time.

This brings me to the second reason I wrote this; everything out there that you can google about IQ, about IQ tests or about how your brain and environment interact to make you act smart, tends to be terrible. As I write this, I have a "Cracked.com" window open and an ad at the bottom is offering me a "Free IQ" test. A google search for "child has a higher IQ than Einstein" returns 1,390,000 results, so I guess Einstein was not all that special. If you want to raise your IQ, then no problem! "Raise your IQ with nutrition" returns 22,000,000 results. Clearly there's nothing to it (please don't give your money to anyone who says they can raise your IQ, and it'll be easy).

I haven't seen very many neutral sources of information on IQ and testing, so here's my attempt at one. If a reader or child of a reader has had an IQ test, then I don't know how they did or what challenges they are now facing, so nothing here is a substitute for direct help from a professional. I'm also not going to follow this blog up with a "raise your IQ 20 points!" diet or video or computer game, but to not write anything, is to throw up my hands and give up the internet for the people who use fake information to sell fake products and services.