I recently spoke with Dr. Nancie Spector about psychological assessments, the behaviors that indicate an evaluation might be necessary, therapy, and other helpful interventions. As providers of Fast ForWord, a common intervention for children with language or auditory processing struggles, we are always interested in learning more about how to help all students.
About Dr. Spector
Dr. Spector is a child clinical psychologist with over 30 years of experience. She specializes in psychological assessment and psychotherapy for children and adolescents, but works with patients of all ages, including adults. Her areas of expertise include learning disabilities, autism spectrum disorders, anxiety, mood disorders, and dealing with loss. She uses a certified facility dog, Robert, in most of her sessions and currently practices in New Canaan, CT.
When to Visit a Clinical Psychologist
People usually visit Dr. Spector because their child is having trouble learning to read or write, or is exhibiting behavior problems at home. These behaviors can include tantrums that persist well after they’re developmentally appropriate, sleep difficulties, or eating problems. Parents often express concern that their child isn’t keeping up in school the way that he or she should be or they get a standardized test back and the child has not done well. This leads to questions about what that means.
To Proceed or Not to Proceed with an Evaluation
Once an evaluation has been requested, Dr. Spector always meets with the parents first for a consultation session in which she takes a thorough history. This session often involves giving parents suggestions on how to handle certain behaviors. If she suspects that the child might have a language or motor issue, she may refer the family to an occupational therapist or speech and language pathologist for therapy, evaluation or interventions.
Depending on what is learned during the initial consultation, Dr. Spector then decides whether or not to do the evaluation. Parents are told to assume that the evaluation process is going to take 20 visits. This is because Dr. Spector doesn’t want fatigue to impact the results and sees the children for only 45 minutes at a time. She knows that anybody can have a bad day or a bad couple of days. She believes it’s important to see each child over a variety of sessions. That way she can get an accurate picture.
Dr. Spector has parents fill out rating scales (as many as 10 different scales). If the child is in a school that’s receptive, and the parents agree, the school is also given rating scales to complete. However, it is important to note that school participation is not a requirement. She then does the remaining sessions with the child, scores all testing, and meets with the parents to go over results and make recommendations.
How Early Can a Child Be Assessed?
Interestingly, Dr. Spector can do cognitive testing on babies and has worked with infants as young as 1 month old. However, people only tend to bring in infants when there is a premature or multiple birth. As a result, Dr. Spector has seen many sets of twins and triplets who were referred by their family pediatrician. She also sees a number of children around one and a half years old, when parents have concerns about a child experiencing excess anxiety. It is also at this age when parents question whether or not their child might have autism. This is one of Dr. Spector’s specialties. In addition, she conducts extensive parent guidance work to help parents support their child at all stages of development.
What to expect for recommendations
Once it has been determined that an intervention is needed, Dr. Spector may recommend a specific kind of language therapy or an audiological evaluation to determine if there is an auditory processing disorder. She may suggest that the parents consider placing their child in an alternative school (such as Windward, Eagle Hill, or Villa Maria) to address a learning issue or make recommendations for the current school to implement. Occupational therapy, language therapy, or a reading specialist may also be warranted. For some children, she recommends psychotherapy or medication. This depends on whether the child has a learning disability or an emotional problem. Dr. Spector utilizes cognitive behavior therapy. She teaches individual dialectical behavior therapy (DBT) skills training to children as young as 7 years old. She also teaches skills to parents.
Dr. Spector’s furry assistant
One of the things that makes Dr. Spector unique is her use of a certified facility dog, named Robert, during her sessions. Her office is the only place in the whole state of Connecticut, other than Gaylord Hospital, that has one. Robert is present in nearly all sessions. However, a patient may request that he not be present. Dr. Spector says the dog has an amazing impact. He just makes everybody feel better. Because of this, she uses him a lot as a reinforcer. Robert was trained how to do fifty commands. He can open doors, close drawers, and do all kinds of things. At times, Dr. Spector will ask patients to complete a task and then have Robert do a little demo of things he knows how to do once the work is finished. “The kids love him,” she says. “He’s like magic.”
Assessments can lead to good interventions and solid results
The most important thing Dr. Spector would like parents to understand is that pretty much anything can be helped. She believes parents sometimes hesitate to take their kids for an evaluation. They think they’re going to find out something and there won’t be anything to do about it. And that is not the case. She recalls a female patient who went to a special school for 4 years. Dr. Spector retested the student afterwards and she didn’t need any accommodations for college. She even placed out of freshman English!
Dr. Spector has seen some pretty dramatic results with good interventions and stresses that the younger the better when addressing concerns. If you address the issues when the child is as young as possible, the problems are often much easier to treat.