Why Are Neurodevelopmental Assessments So Important?

May 6, 2022 The Ed Psych Practice No Comments Referrals Attention, Cognition, Executive Functioning, Motor, Neurodevelopment, Paediatricians, Sensory, Speech and Language

Takeaway: A neurodevelopmental assessment tells you whether or not your child is developing as expected. It uses tests and observations to explore key markers like motor skills, cognition, memory, attention, and more. Based on this, you’ll get a concise developmental profile that can help you maximise your child’s potential.

Children’s brains grow quickly and early. So, as parents, we need to monitor our children’s development carefully.

A baby’s brain at birth is about one-fourth the size of an adult’s, but it grows rapidly. After just one year, it doubles in size, and it’s 90% developed by age 5. Moreover, its brain cells begin to lay down intricate pathways, forming about a million new connections every second from birth to age 3! These pathways give babies new abilities to think, move, and communicate – plus, they improve higher-level meta-skills like the capacity to stay motivated and regulate emotion. Crucially, all this doesn’t happen in isolation. Genes control how brain-cell connections are made, but a baby’s experiences (e.g., interactions, adult love/support, mental stimulation, etc.) affect how these new connections are used. So, those early years can quite literally shape a child’s future life – which is why it’s so important to monitor her brain and nervous system as they mature.

A neurodevelopmental assessment is a powerful tool to track a child’s progress and recognise brain differences during these early years.

A child’s brain can develop ‘typically’ or ‘atypically.’ By ‘typical,’ we mean that her brain and nervous system develop along the same path outlined by data and statistics from children over decades of scientific study. It’s the type of development most parents would expect. ‘Atypical’ development means that a child’s brain and nervous system develop along a different path. (Note that the word is ‘different,’ not ‘better/worse’ or ‘normal/abnormal.’) Examples of atypical brain development include diagnoses like ADHD, autism, dyslexia, dyspraxia, and more – many of which might overlap (e.g., a child with ADHD might also have dyslexia). So, clearly, there’s a lot to track, and neurodevelopmental assessments are the best way to diagnose these differences.

It’s not just about making diagnoses, though. It’s about understanding your child’s developmental profile.

At first glance, a neurodevelopmental assessment seems to be just a bunch of clinical tests and observations. But making a diagnosis is just the starting point. Ideally, we’re trying to create a holistic profile of your child – of patterns in how she thinks, feels, behaves, interacts, adapts, and more. And through this profile, we’ll explore her strengths and weaknesses and how these might interact.

But the profile can’t just be a theoretical analysis. It needs to be something we can apply to real-world scenarios.

An assessment needs to account for the fact that anything a child does is influenced by the situation she’s in. Let’s take ‘making eye contact’ as an example – which is an integral part of healthy socialising. Tests might reveal that a child doesn’t make eye contact often – and sure, that’s useful information. But there’s so much more to find out. For instance, is she willing to make eye contact to encourage someone to give her a toy? And if so, does she use it only as a tool to get what she wants, or does she recognise that it’s a valuable form of communication? We don’t just want to know about the abstract concept of eye contact. We want to know if a child can apply the concept to complex real-world scenarios. And it’s this sort of practical profile we’re looking to create.

So what goes into an assessment? Well, it involves a coordinated group of specialists exploring a range of traits and abilities.

Assessments vary depending on your child’s needs, and might involve multiple specialists like paediatricians, educational psychologists, speech & language therapists, and occupational therapists.

We’ll need to take a detailed medical history, ask you questions about your child, and run any extra tests, if needed. Usually (but not always), we’ll assess the following broad areas – all scaled up or down, depending on how old your child is.

1. Brain structure

We’ll measure things like the circumference of your child’s head, to check for changes in overall brain size. And if needed, we’ll investigate further by using brain imaging to explore the relative size and structure of different parts of her brain. Through this, we can learn about your child’s risk for seizures, cerebral palsy, vision issues, etc.

2. Motor skills

We’ll use standardised tests as well as direct observation (of your child playing, learning, etc.) to spot issues with fine motor skills (e.g., grasping a pen with her fingers), gross motor skills (e.g., throwing/catching a ball), and more.

3. Cognition

We’ll use standardised tests(for children age 2 and above) to measure your child’s IQ, working memory, verbal/non-verbal reasoning skills, and more.

4. Language

We’ll evaluate your child’s ability to talk about her thoughts and feelings (i.e., expressive language) and her ability to understand the ideas and emotions of others (i.e., receptive language).

5. Academic skills

This includes things like reading, writing, spelling, and maths abilities. We can test these directly, as well as look at supplementary data from school reports.

6. Memory

This covers your child’s memory as a whole and more specific elements like verbal memory (e.g., remembering lists of words, word sequences, and stories) and visual memory (e.g., remembering faces and objects).

7. Attention

This includes things like focusing on a single task (e.g., ignoring a noisy classroom while listening to a teacher), focusing on multiple tasks (e.g., listening – and singing along – to a song while walking), and switching between tasks (e.g., listening to a song while following directions on a map).

8. Executive functions

These are higher-order skills that help us monitor ourselves, regulate our behaviour, and work towards goals. (Learn more about executive functions.) In an assessment, we’re evaluating elements like impulse control, hyperactivity, and problem-solving.

9. Emotion/mood regulation

Here, we’re assessing your child’s ability to control short-term, intense emotions and longer-term, less-intense emotional states (i.e., her moods). Regulating emotions and moods is vital for surviving stressful situations, and issues here can predict mood disorders (e.g., depression) and anxiety disorders (e.g., generalised anxiety disorder).

10. Adaptive skills

We’ll also want to explore your child’s ability to look after herself and get along socially. This means assessing her self-care skills (e.g., washing hands, brushing teeth, staying hydrated) and social skills (e.g., communication, empathy, and ability to make/keep friendships). Adaptive skill deficits often show up in developmental differences like autism spectrum disorder and social communication disorder.

It takes skill and experience to make these assessments, though. So, you’ll need the help of trained specialists.

Specialists go beyond standardised tests and pick up on the tiniest clues when creating your child’s developmental profile. Clues like tics (repetitive sounds/movements), anxiety, distractedness, low motivation, etc. And this takes skill, experience, and a lot of patience. So, to find the right specialists for your child, feel free to reach out to us for help. At The Ed Psych Practice, we offer face-to-face and online assessments, consultation, advice, and problem-solving strategies for parents, nurseries, schools, and universities in London. We have psychologists, paediatricians, and therapists who can help assess your child and offer guidance and support. To consult with us or set up an appointment:

Phone: +44 (0) 78 3344 7356
E-mail: Office@TheEdPsych.com