Last week, we presented the first part of a two-part series on unraveling the ED/SM dilemma. This week, we talk to the experts on how to use various assessments to evaluate emotional disturbance and social maladjustment.

Catch up on last week's blog here.

School staff members often have difficulties when it comes to assessing a student who may have emotional disturbance (ED), and getting hard data to back up the decision can be just as difficult. PAR spoke with experts in the field about the use of various instruments that have proven to be useful in gathering the hard data needed in order to make an informed decision about ED eligibility.

Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2)

Peter K. Isquith, PhD, is a practicing developmental school neuropsychologist and instructor in psychiatry at Harvard Medical School. He’s the coauthor of the BRIEF2, the new BRIEF2 Interpretive Guide, and the Tasks of Executive Control (TEC).

PAR: Why would it be helpful to include a measure of executive functioning in the assessment of a student being evaluated for an ED eligibility?

PI: In general, the purpose of including the BRIEF2 when asking about ED is to know whether or not the child actually has an emotional disturbance or if his or her self-regulation gives that appearance. So, if a child is referred who has frequent severe tantrums, we want to know if this is an emotional disturbance or if it is part of a broader self-regulatory deficit. That is, is the child melting down because he or she truly experiences emotional distress? Or is he or she doing so because of poor global self-regulation? To answer this, I would want to look at two things:
Is there evidence of an actual emotional concern? Does the child exhibit mood problems, anxiety, or other emotional issues?
And does the child's self-regulation have an impact on other domains, including attention, language, and behavior? That is, is he or she physically, motorically, attentionally, and/or verbally impulsive or poorly regulated?

If the first answer is yes, then there is likely an emotional disturbance. But if it is no, then there may be a self-regulatory issue that is more broad. By using the BRIEF2, clinicians can quickly learn if a student is impulsive or poorly regulated in other domains, not just emotionally. A BRIEF2 profile with high Inhibit and Emotional Control scales suggests that the child is more globally disinhibited. If it is primarily the Emotional Control scale that’s elevated, and there is an emotional concern like mood problems, then it may be more of an emotional disturbance.

Pediatric Behavior Rating Scale (PBRS)

Richard Marshall, EdD, PhD, is an associate professor in the Department of Educational and Psychological Studies in the College of Education at the University of South Florida. He is also an adjunct associate professor in the Department of Psychiatry and Behavioral Neurosciences at the USF College of Medicine. In addition to the PBRS, published in 2008, he is the author of 2011’s The Middle School Mind: Growing Pains in Early Adolescent Brains.

PAR: How does the PBRS fit into the diagnosis of ED?

RM: Two gaps in practice prompted us to develop the PBRS. The first was that the assessment instrument available at the time had few if any items about rage attacks, irritability, assaultive aggression, and other symptoms associated with early onset bipolar disorder. Hence, despite significantly abnormal behaviors, results of assessments were often within normal limits because they failed to capture symptoms of interest. So, our first goal was to include these new behaviors into parent and teacher ratings.

A second problem was that symptom overlap between ADHD and early onset bipolar disorder made it difficult to differentiate ADHD and bipolar disorder. The problem is that the standard treatment for ADHD, stimulant medication, induces mania in individuals with bipolar disorder. Thus, diagnosis accuracy is paramount.

What we learned during the PBRS norming sample was that students with ADHD and bipolar disorder produce a similar pattern of scores, but students with bipolar disorder produce a higher level of scores. That is, both groups have similar symptoms, but individuals with bipolar disorder have more serious symptoms. Thus, the PBRS can assist clinicians in differentiating individuals with mood disorders from those with ADHD.

PAR: Decades of research in cognitive neuroscience, combined with changes in our understanding and classification of mental illness in children, impels us to continually reevaluate theory and practice. Formulated more than a half-century ago, the idea of social maladjustment is one of those policies in desperate need of revision. In 1957, the idea of being able to identify students who were socially maladjusted may have seemed reasonable.

RM: There are two problems with this idea. First, the government has never defined social maladjustment, and states (and practitioners) have been left without clear ways of differentiating students who are or are not socially maladjusted. Second, without a clear definition, the concept of social maladjustment has created what Frank Gresham refers to as a “false dichotomy” that is used to exclude students from receiving interventions that would help them and to which they are entitled.

Emotional Disturbance Decision Tree (EDDT)

Bryan Euler, PhD, author of the EDDT as well as the EDDT Parent Form and the new EDDT Self-Report Form, has a background in clinical and counseling psychology, special education, and rehabilitation counseling. He has 27 years of experience as a school psychologist working in urban and rural settings with multicultural student populations.

PAR: Can you describe the overall benefits of the EDDT system and what makes it unique from other instruments?

BE: The EDDT series was designed to map directly onto the IDEA criteria for emotional disturbance, which are different from and broader than constructs such as depression or conduct. The federal criteria are, some might say, unfortunately wide and “fuzzy,” rather than clean-cut. The EDDT scales are written to address these broad domains thoroughly and help school psychologists apply the unwieldy criteria.

The EDDT also includes a social maladjustment scale (SM). Since students who are only SM are not ED eligible, the EDDT is useful in ruling out these students and in identifying those for whom both conditions may be present. This can be helpful with program decisions, so children or adolescents who are primarily “fragile” are not placed in classrooms with those who have both depression/anxiety and severe aggression.

The EDDT also has an Educational Impact scale, which helps to document that the student’s social-emotional and behavioral issues are having educational effects, which IDEA requires for eligibility. All of the EDDT forms include a Severity scale, which helps to gauge this and guide service design.

The EDDT Parent and Self-Report forms also include Resiliency and Motivation scales, which help to identify a student’s strengths and determine what may most effectively modify his or her behavior. The presence of all these factors in the EDDT scales is intended to facilitate the actual practice of school psychology with ED and related problems.

PAR: Why is it important to have multiple informants as part of an evaluation?

BE: Having multiple informants is, in effect, one way of having multiple data sources. Multiple data sources add incremental validity, or accuracy, to evaluations as well as breadth of perspective. A rough analogy might be to lab tests, which are often done in panels, or multiples, rather than in singles, to help with insight, efficiency, and decisions.

PAR: What are the benefits of having the student perspective as part of an evaluation with multiple informants?

BE: Having a student’s perspective on his or her behavior and social-emotional adjustment is a critical but sometimes overlooked component of assessment, especially for ED and ADHD evaluations. If only teacher anecdotal reports, teacher-completed ratings, and behavior observations are used, this vastly increases the chance that the evaluation will be skewed toward externalized behavior like aggression and rule-breaking. Internal factors such as depression or anxiety, which may be causing the behavior, will be deemphasized, if noted at all. Research corroborates that if teachers rate a student, and ratings are also obtained from the parent and the child, the teacher results tend to highlight difficult, disruptive behavior, while other ratings may result in other insights. Relatedly, in children and adolescents, depression is often primarily manifest in irritability or anger rather than sadness. If there is no observable sadness and only problem behavior, teacher ratings may understandably focus on what stands out to them and complicates classroom management.

Even if students minimize their depression, anxiety, or social problems, they do sometimes rate one or more of these as “at risk.” This can provide a window into subjective emotional pain that may otherwise be obscured. Finally, gathering student-derived data enhances school psychology professional practice. Psychologists who complete child custody or juvenile corrections evaluations gather data directly from the child to facilitate insight, which can also aid in school psychology.

Adolescent Anger Rating Scale (AARS)

Darla DeCarlo, Psy S, has been a clinical assessment consultant with PAR for nine years. She is a licensed mental health counselor and certified school psychologist in the state of Florida.

PAR: Can you speak about your use of the AARS in ED evaluations?

DD: Within the context of assessing those students referred for behavior-related evaluations, I found the AARS to be a great compliment to the various other instruments I used during the evaluation process. Making an ED determination is a sensitive issue, and I wanted as much hard data as possible to help me make a well-informed decision. The AARS allowed me to assess a student’s level of anger and his or her response to anger through a self-report. Limited instruments are able to give clinicians information that can help them look at the ED/SM issue. The AARS helped me identify students who were at risk for diagnoses of conduct disorder, oppositional defiant disorder, or ADHD. Combine these results with results on the EDDT and other instruments, and I was able to get a good picture (not to mention some hard data) on whether SM factored into the student’s issues.

PAR: What about interventions? Does the AARS help with that in any way?

DD: Anger control, as defined by the AARS, “is a proactive cognitive behavioral method used to respond to reactive and/or instrumental provocations. Adolescents who display high levels of anger control utilize the cognitive processes and skills necessary to manage anger related behaviors.”

What I liked about the instrument is that it qualifies the type of anger the student is displaying and then gives the clinician information about whether or not the student displays anger control or even has the capacity for anger control. As a school psychologist, I needed to know if the student already had the skills to follow through with some of the possible interventions we might put in place or if we needed to teach him or her some skills before attempting the intervention. For example, something as simple as telling a student to count to 10 or walk away when he or she feels anger escalating may seem like an easy task, but not all students recognize the physiological symptoms associated with their outbursts. Therefore, asking them to recognize the symptoms and then act by calming themselves is pointless. I have seen this mistake many times, and have made the mistake myself by suggesting what I thought was a useful and effective intervention, only to find out later that the intervention failed simply because the student did not possess the skills to perform the task. The AARS gave me information that helped guard against making this type mistake.

As with every evaluation, the instruments we choose in our assessments are important, but even the best instrument is useless without the keen skills of well-trained school staff to properly administer and interpret results with accuracy and precision.

This is the first part in a two-part series. Come back next week to learn more from our experts and authors.

Katherine is an 8 year old who attends public school. Following a traumatic event, she began to insist on wearing a helmet to school and during class. When school personnel requested she remove the helmet, she adamantly refused, expressing fear that the ceiling would fall and they would all be killed. Her grades have dropped considerably, and she is having problems socializing with peers. Her mother reports similar disruptions at home. Katherine’s grades have dropped to Ds and Fs, and her behavior has become disruptive in class. She cries frequently and has most recently expressed a desire to stay home from school.

Jeremy is a fifth grader who currently receives special education services under the category of emotional disturbance (ED) and other health impaired (OHI). One year after his initial ED diagnosis, he was diagnosed with autism spectrum disorder (ASD). His original ED eligibility was based on violent behavior in kindergarten and first grade. Once it became evident that his violent outbursts were related to characteristics associated with his ASD diagnosis and appropriate interventions were put into place, Jeremy was able to function more effectively at school. His grades are above average, and he has not experienced any behavioral outbursts since second grade. His parents are planning to place him in a private school and have requested an evaluation to eliminate the ED diagnosis. They believe the OHI eligibility is the most appropriate eligibility for him; the school administration and teachers agree.

Brian is a 15 year old who was expelled from his last school for calling in a bomb threat. The administration at his home school considers him occasionally volatile and “a constant liar.” His mother confirms the lying and additionally reports daily fights between Brian and her live-in boyfriend. She states that “he hangs with a bad crowd, and his behavior is out of control.” Brian’s teachers describe him as a loner who appears sad throughout the school day. His grades have dropped from Bs to Ds and Fs.

These three cases exemplify the diversity and difficulty inherent with evaluating students who have been referred for a comprehensive assessment due to academic and/or behavioral concerns.

History of ED Prevalence

In the 2001-2002 school year, there were 6.3 million students in special education programs. Of these, 473,663 were classified as emotionally disturbed, according to the National Center for Education Statistics—a number that had increased 18.4% from the previous 10 years (1991-1992). By 2002, ED had become the fourth most prevalent of the 13 exceptionalities served by special education, and there was every indication that an increase in both number and proportion for this group would continue to occur.

Instead, we began to see a decline. By the 2011-2012 school year, only 373,000 students were classified as having ED.  It appeared the numbers were dwindling.

Yet, recent research has reported that parents and caregivers of more than 8 million school-aged children ages 4 to 17 years have sought help from a mental health professional or school staff member about their child’s emotional or behavioral difficulties.

Clearly, questions arise. What accounts for the disparity between those asking for help and those receiving services? How do we account for what appears to be an under-identification of ED in the schools? What can we put in place to stop the decline and get those who require help the services they need?

The Difficulty with ED Eligibility

Students with emotional disturbance are especially difficult to assess and identify, and the evaluation itself is time consuming. Whether determining, changing, or removing eligibility, clinicians usually have an idea of who needs help emotionally. However, determining whether a student qualifies for special education services within the Individuals with Disabilities Education Act (IDEA) category of ED can be complicated.

One of the greatest challenges in determining eligibility services involves the social maladjustment/emotional disturbance dichotomy. The term socially maladjusted (SM) has not been defined by IDEA. The federal definition of ED, which was written in 1957 and remains virtually unchanged, leaves the operationalization of the criteria set forth by IDEA to individuals and organizations in the field along with state and local educational agencies, who are responsible for implementing special education services.

To further complicate matters, we have only recently begun to question the longstanding belief that SM students externalize their behaviors, while ED students internalize their behaviors. However, since ED was defined in 1957, neuroscience has shown that “brain differences underlie both internalizing and externalizing behaviors,” says Richard M. Marshall, EdD, PhD, author of the Pediatric Behavior Rating Scale (PBRS). “From a neurobiological perspective, therefore, the only difference between the two is the expression of behavior. There is little evidence that students with externalizing behaviors are any more capable of controlling their emotions or behavior than students with internalizing disorders. Yet students with internalizing disorders are provided with interventions, while students with externalizing behaviors are punished.”

In addition to the difficulties defining and determining SM versus ED, the federal criteria definition includes two potential areas of ED eligibility that are very broad and have no clinical definition:

• “An inability to build and maintain satisfactory interpersonal relationships with peers and teachers.”


• “Inappropriate types of behavior or feelings under normal circumstances.”Also, the Office of Special Education Programs (OSEP) has never provided official guidelines for potential exclusionary criteria for an ED diagnosis such as severity, educational impact, and duration. Although some feedback on these issues has been provided, no formal guidelines have been published. The federal definition does allude to some clinical conditions (e.g., depression, anxiety, and schizophrenia), but it doesn’t provide guidelines for how these conditions should be diagnosed.Lastly, we cannot negate the fact that in the past, psychologists lacked psychometrically sound instruments to provide them with the hard data needed to substantiate a well-informed decision in regards to ED eligibility.

Come back next week to learn more on this topic from our experts.

Sometimes, measuring a client’s or student’s overall intellectual ability isn’t as simple as administering the RIAS-2 , the TOGRA, or the RAIT. Sometimes, very young children; those who speak English as a second language; and those with communication or speech disorders, attention disorders, autism spectrum disorders, traumatic brain injury, and other conditions have difficulty on traditional tests of IQ—and they may be underserved simply because they can’t be tested accurately.

The Vocabulary Assessment Scales (VAS) offer an alternate way to assess overall intellectual ability by measuring expressive and receptive vocabulary ability. Research has shown that vocabulary ability correlates strongly with cognitive ability, so professionals can confidently use data from the VAS to estimate general intelligence in individuals ages 2 years, 6 months to 95 years. The VAS correlates strongly with the Reynolds Intellectual Assessment Scales (RIAS), a trusted measure of general intelligence.

Help uncover your client’s intellectual abilities and get them the help they need to succeed.

With very little motor skill required, and no reading or writing necessary, the test is suited for those who have difficulties taking traditional IQ tests.

The VAS uses modern, engaging photographs (not outdated line drawings, like other picture vocabulary tests) to gauge expressive and receptive language ability. It offers digital stimuli (available on an iPad) to engage younger clients, and scoring is available on PARiConnect, our digital assessment platform.

The VAS-Expressive asks test-takers to look at a picture and answer, “What is this?” Items were generated so the number of possible one-word answers was limited. The VAS-Receptive asks test-takers to respond to questions like, “point to the frog” when presented with an array of four possible answers. There are few overlapping items between the receptive and expressive versions, which helps reduce practice effects.

In addition, each test includes two equivalent forms (A and B) with no overlapping items and reliable change scores, making it a useful tool for measuring response to intervention (RTI) in school-based reading programs, medical settings, or after injury or illness.

The VAS is the only picture vocabulary test that provides a composite score and a reliable change score. It also features less complicated basal and ceiling rules, so it’s easier to administer and score than similar measures.

Each test only takes about 15 minutes to administer, and normative data are provided for 28 different age groups and for Grades K-12 (spring and fall).

For more information about the VAS, visit www.parinc.com or call 1.800.331.8378.

Whether you need to screen, diagnose, or track individuals on the autism spectrum, the PDD Behavior Inventory™ (PDDBI™) family of products has what you need. The original PDDBI was developed to assess both problem behaviors as well as appropriate social, language, and learning/memory skills. The two newest supplements to the product line expand its use, making it even easier to diagnose, track, and assess autism spectrum disorder.

Now available! The PDDBI Professional Manual Supplement: Autism Spectrum Decision Tree (ASD-DT)

The ASD-DT is designed to enhance the diagnostic power of the PDDBI. Once a parent or teacher has completed the Extended Form, the ASD-DT allows you to use those scores to complete the branches of a decision tree that ultimately results in a diagnostic category. An algorithm is used to transform PDDBI scores into subgroups of ASD (Atypical ASD, Minimally Verbal ASD, or Verbal ASD) as well as non-ASD subgroups. Intervention suggestions and further recommendations are provided for all subgroups. The ASD-DT is designed to be used with individuals ages 1:6 to 12:5 years.

Now available! The PDDBI Professional Manual Supplement: Adolescent Normative Data

This new supplement extends the age range of the PDDBI normative data to age 18:5 years. Ideal for use when monitoring progress over time, this extension to the normative data can be used with both parent and teacher ratings on the PDDBI. The standardization sample includes individuals from a range of racial and ethnic backgrounds and geographic regions. The adolescent normative data are appropriate for use when either the standard or extended items are administered.

Whether you are a PDDBI user who wants to expand its use in your practice or are new the PDDBI family of products, visit www.parinc.com today to order the materials you need!

 

The latest test from popular author Cecil R. Reynolds, PhD, the new Reynolds Interference Task (RIT) is a test of complex processing speed that assesses general neuropsychological integrity.  It is suitable for measuring the effects of traumatic brain injury, stroke, dementia, Alzheimer’s disease, and brain tumors. It is also useful as a measure of attention and complex processing speed deficits and as a rapid means of measuring recovery from concussion.

Measurement of speeded processing is popular in psychological testing, and most measures are exceedingly simple. Measuring how quickly one can perform simple tasks that, given unlimited time, almost everyone would complete perfectly is a reflection of speeded processing. The RIT adds a layer of cognitive processing difficulty—inhibition and attention-shifting—to simple tasks, which slows performance and requires extra mental effort, making the tasks more complex and thus more indicative of cognitive flexibility and selective attention.

The RIT features two timed Stroop-style subtests, Object Interference and Color Interference, which combine to provide a Total Score. This provides greater coverage, enhanced consistency, and more reliability than similar measures featuring a single subtest. It was designed to provide continuity of measurement across a wide age range, so it is appropriate for individuals ages 6 to 94 years. The subtests require minimal motor demand and can be administered in just 90 seconds.

Like intelligence and memory assessments, mental speeded processing (or decision speed) can be a crucial contributor to the diagnostic process for a variety of disorders, particularly those associated with compromised neuropsychological integrity.

Conormed with the Reynolds Intellectual Assessment Scales, Second Edition (RIAS-2), the RIT includes a large standardization sample (N = 1,824) representative of the 2012 U.S. Census and includes reliable change and discrepancy scores. It’s the best of all possible psychometric worlds.

For more information, visit www.parinc.com or call 1.800.331.8378.

Nearly 39 years ago, R. Bob Smith, III, PhD, and his wife Cathy began publishing two psychological instruments out of their home. Bob was a practicing psychologist and saw a need in the market for scoring keys and supplemental profile forms for the MMPI, assessments he was using in his own practice. Today, the table where Bob started PAR sits in the break room of PAR’s distribution center.

“I never envisioned that PAR would become the company it is today,” said Cathy.

Over the next nearly four decades, PAR has grown to be a leading publisher of psychological assessment materials. As of Friday, March 31, Bob will begin the next step of his career with PAR when he assumes a new position as Executive Chairman and Founder. In this new position, he will be involved in broad strategic leadership, governance, and consultation to the company.

Cathy will transition from Vice President of Community Relations to Vice President of Community Relations Emeritus. She will continue to consult on the philanthropic and community activities that are pivotal to the core values of the company.

Kristin Greco, MBA, Bob and Cathy’s oldest daughter, will be stepping into the role of CEO, and continuing the Smith family vision for PAR. Kristin has spent the last 6 years working at PAR, learning the core values, culture, and commitment to excellence you have come to expect from PAR. This is an exciting time of transition for the whole PAR family.

“I grew up with them packing all of the orders in our carport, surrounded by boxes,” said Kristin. “I grew up seeing PAR grow. It’s a blessing to be able to work with your family; it’s an honor to continue the tradition developed by your parents.”

Bob and Cathy have devoted the last 39 years to building an extraordinary company that publishes quality assessment products, provides exceptional Customer Service, and treats employees like family. We look forward to the next chapter in the PAR story.

 

This article refers to products that are no longer available or supported.

March is brain injury awareness month. Concussions are sometimes described as a mild brain injury because they are not usually life-threatening, but the effects of concussions can be incredibly serious. PAR offers two apps that can be used by individuals who are concerned with treating and diagnosing concussions.

The Concussion Recognition & Response™ (CRR) app helps coaches and parents recognize whether an individual is exhibiting and/or reporting the signs of a concussion. In fewer than 5 minutes, a parent or coach can complete a checklist of signs and symptoms to help determine whether to seek medical attention. The app allows users to record pertinent information regarding the child with a suspected concussion, allowing them to easily share that information with health-care providers. Post-injury, it guides parents through follow-up treatment.

The Concussion Assessment & Response™: Sport Version (CARE) app is a tool for athletic trainers, team physicians, and other qualified health care professionals to assess the likelihood of a concussion and respond quickly and appropriately.

The CRR app is available free of charge. The CARE app costs just $4.99. Both apps are available for download through the Apple® App Store^SM and Google Play for use on your iPhone®, iPad®, iPod® Touch,  Android™ device, or tablet!

 

PAR is currently collecting normative, reliability, and validity data for a number of new products in development. Data collectors are responsible for obtaining test subjects based on the specific project needs as outlined by the Data Collection Coordinator and are compensated on a "per case" basis that varies with each project. Typically, we offer examiners/data collectors an option for either cash payments or credit toward PAR products. We also have provisions for compensating examinees. PAR pays for all shipping and handling fees arising from data collection. If you are interested in collaborating with PAR as a data collector, complete the Examiner Information Form.

For more information on the data collection process, visit this page.

 

The MEMRY is the first nationally standardized rating scale specifically designed to measure memory in children, adolescents, and young adults. It measures everyday memory, learning, and executive aspects of memory, including working memory.

It provides rapid screening for memory problems in youth, an ecologically relevant assessment of memory in everyday life, and multiple perspectives about memory capacity from different raters. The MEMRY can be used to determine whether a more comprehensive evaluation is required or as a core component of a comprehensive assessment for youth suspected of memory problems.

The MEMRY:

• Features both informant (ages 5-19 years) and self-report (ages 9-21 years) forms.


• Includes an overall score, the Everyday Memory Index (EMI), as well as scales that tap learning, daily memory, and executive/working memory and three validity scales.


• Allows clinicians to differentiate between problems caused by memory failures versus failures due to problems with working memory and attention, a common referral question.


• Appropriate for use with typically developing youth, as well as individuals with suspected memory or learning problems.


• Provides intervention recommendations based on MEMRY scores.

The MEMRY was conormed with the Child and Adolescent Memory Profile™ (ChAMP™) and the Memory Validity Profile™ (MVP), providing a full suite of memory products!

Learn more about the MEMRY today!

Since 2000, school psychologists have turned to the Behavior Rating Inventory of Executive Function (BRIEF) to examine executive function in the everyday, real-world environments of children ages 5 to 18 years. A revision to that groundbreaking test, the BRIEF2, was published in 2015. Featuring more concise scales, increased sensitivity to executive function problems in key clinical groups like autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), and new screening forms for parents, teachers, and students, the BRIEF2 is the gold-standard for executive function testing.

A new companion piece, developed and written by the BRIEF2 authors, is now available.

The BRIEF2 Interpretive Guide helps school psychologists and educators gain a deeper understanding of BRIEF2 scores, write reports, plan intervention strategies, and monitor progress of students with executive function concerns.

Using case examples of students with ASD and ADHD and written in a straightforward, reader-friendly style, the authors weave a narrative that will be familiar to most education professionals. This helpful guide offers optional interpretive steps and demonstrates uses for screening, basic, and advanced interpretation.

Included are step-by-step guides to interpreting BRIEF2 scores and parallel sentence-by-sentence guides to help professionals write findings in reports using language that is concise, accurate, and clear to parents and teachers.

“It is so enjoyable to witness how outstanding clinicians learn what they know, teach what they know, and practice what they know,” writes Elaine Fletcher-Janzen, EdD, ABPdN, professor of school psychology, in the book’s foreword. “This book is a glimpse into how clinical practice and the assessment and treatment of EF should be done, or how the experts do it. The reader is left with a comforting thought that if the practices and recommendations in the book are followed, then the best has been done for the child and the family. I feel very comfortable handing this book over to my students and saying, Do what they do!”

The BRIEF2 Interpretive Guide is available in both hardcover and electronic formats. Order or learn more.