Neuropsychological Evaluations Through a Cultural Lens

I recently had the pleasure of joining Dr. Karen Wilson on her new podcast, Diverse Thinking/Different Learning, to discuss pediatric neuropsychology through a cultural lens. The podcast focuses on relevant information about learning differences, learning disorders, and emotional difficulties students experience. Have a listen:…/

Show Notes:

[0:48] – Karen introduces Dr. Fernandez and gives her background. Dr. Fernandez is the founder of the Center for Pediatric Neuropsychology to address the growing need for culturally and linguistically appropriate evaluations for Latino/a children.

[2:16] – Dr. Fernandez defines a psychoeducational evaluation, as that is the most commonly used assessment offered to parents of school-aged children struggling in an educational setting. It entails different tests that serve the purpose of identifying areas of academic need.

[3:40] – A neuropsychological evaluation is not a specific type of evaluation but more an assessment performed by a neuropsychologist. This type of psychologist has extensive training in brain-behavior relationships and neuroanatomy.  

[5:19] – A neuropsychological exam not only helps identify the learning difficulties a child may have, but also gets deeper into the medical side of things to find possible underlying medical issues.

[7:01] – The purpose of an evaluation in schools is different than the evaluations done when a parent goes to see a neuropsychologist like Dr. Wilson or Dr. Fernandez. 

[7:26] – Dr. Fernandez explains how school evaluations work and the purpose they serve in informing services and accommodations in a school setting. There are specific legal mandates on how these evaluations are conducted.

[8:50] – Psychologists in a private practice have a lot more flexibility in diagnosing as opposed to the more narrow guidelines of a school evaluation conducted by a school psychologist.

[9:36] – An evaluation is only as important or as valid as the recommendations you impart to the family. A diagnosis is important but it is what you do with that information that is the most valuable.

[11:04] – Dr. Fernandez wrote an article about dyslexia and today she discusses some of the reasons why students could have trouble reading.

[13:54] – The intervention and accommodations that are recommended as a result of the evaluation will certainly differ depending on what those results are.

[15:31] – Oftentimes there is more than one issue that the student is struggling with. All issues need to have an intervention simultaneously. Dr. Fernandez explains why that is important.

[17:32] – Dr. Fernandez explains that there was a time when Spanish speaking children were evaluated using English language measures to determine whether or not they had intellectual disabilities. They were placed in special education programs en masse.

[18:24] – For a period of time, minority or underrepresented populations were overrepresented in special education.

[18:44] – Several laws have since been passed as a result of some landmark cases in education. Now the instruments have to be validated for the population that it is being used for.

[19:29] – Dr. Fernandez says that when she evaluates a child who doesn’t speak English or didn’t speak English as their first language, her first thought is about the instruments and whether or not they are appropriate for the child.

[20:00] – Something we need to always consider is that some immigrant parents may not have a lot of experience with formal education and may feel uncomfortable in a professional setting.

[21:49] – Developing rapport with parents is important.

[22:37] – The parent interviews and questionnaires that are a part of the evaluation process will vary in detail. Some parents share a lot of information and others do not. Developing trust and explaining why these questions are important is helpful.

[24:39] – Being able to determine what is going on with a child, you have to look at the evaluation and the struggles the child has with a cultural lens.

[25:52] – Dr. Fernandez explains a few perpetuating myths, one being that bilingual children automatically have a limited vocabulary when they learn two languages simultaneously.

[27:42] – We should not overpathologize differences in learning especially when we are talking about children who are growing up differently. But working with specific populations, it is important to be aware of various cultures and backgrounds.

[29:37] – The types of children Dr. Fernandez usually sees are the ones who are struggling in school in comparison to their peers. 

[31:25] – When there’s a level of distress associated with the learning difficulty that can’t be explained by normal development, the behaviors are red flags for a problem that needs to be solved.

[33:21] – Don’t ignore your gut feeling. If you feel that your child is struggling more than their peers, seek an evaluation to determine the root cause of the struggle.