If you are like me, you recently sat down with your kid's teacher to get a report on how the Fall semester is progressing. These days we have a lens into the grades our children earn on a day to day basis, if we desire. One click-click-click into the school portal, and we can often know about that history test grade before sweet thing even gets into the carpool shuffle. (No more hiding that 65 until you could redeem yourself on the next test like in the good 'ole days!) With access to such a constant stream of information, it may have been no surprise to hear your kid's teacher say, "You may want to look into having him tested." But now what? Who does this sort of testing?
That's why we are so excited to bring you this new series on the Story Stage Blog! Over the next few weeks, we will introduce you to some of the fabulous professionals in our community who do testing, tutoring, therapy, and more. We'll talk about their backgrounds, experience, and what they do best. Our hope is to introduce you to some of our most trusted colleagues, to demystify the process of finding help for your child, and to answer some of the questions that you haven't been sure who to ask. We are delighted to start off this series with a conversation with Dr. Neslihan Chandler, one of Fort Worth's most respected psychologists for children and adolescents. She's got a ton of great insight to share with y'all.
Neslihan Chandler, Ph.D.
Why did you decide to become a clinical psychologist?
I actually decided to become a psychologist when I was in high school and I took my first psychology class! I feel in love with the idea of helping children and families through mental health. Once I knew what psychology was, I was driven to get the highest level of education needed to help families.
There are so many professionals who test kids! How do you know whether to get testing from a clinical psychologist or a neuropsychologist or a “regular” psychologist? What’s the difference?
So, there is no such thing as a “regular” psychologist. There are many different types of psychologists: clinical psychologists, clinical child psychologists, neuropsychologists, school psychologists, and even forensic psychologists. Just like any other field, psychology has lots of areas that one can specialize in. A clinical psychologist can specialize in working with adults, working with elders, or working with children. Then within those populations, you can specialize even further (abuse and trauma, depression, anxiety, inpatient populations, outpatient populations, etc.). Some clinical psychologists specialize in assessments and then further specialize in testing with pediatric populations. Neuropsychologists specialize in evaluations with populations who have had significant brain trauma or have a significant medical history (concussion, traumatic brain injury, chemotherapy and radiation, genetic disorders, etc.). However, for more common psychological disorders, such as ADHD, Autism, Learning Disabilities, Intellectual Disability, Anxiety, and Depression; a clinical psychologist who specializes in psychological assessments with children can easily assess for these conditions. Therefore, when looking for a psychologist to assess your child, be sure to ask for referrals from trusted medical professionals, check to see if the clinical psychologist specializes in testing for the condition you are concerned about. Make sure the clinician has the proper credentials to diagnose the condition (Ph.D over a Master’s degree), and ask lots of questions about the process. A skilled clinical psychologist will be able to answer all your questions and provide you with details of how they can help your child.
Who decides that a student needs to be evaluated by you? Do parents need a doctor’s referral?
Anyone who has concerns for the child can decide if the child needs an evaluation. Teachers, parents, pediatricians, school learning specialist, speech therapists, occupational therapists, etc. can all recommend to the parents that a child could benefit from an evaluation. When parents first call me, I spend lots of time asking questions about the referral problem. Once I know what issues needs to be assessed, I offer an individualized plan for the assessment process based on the specific needs of the child. A referral from a doctor is not needed.
What happens to a student after he is evaluated?
After the evaluation, I spend several hours scoring the measures and writing the psychological report. When the report is complete, I schedule an appointment with parents only to go over all the results. I go over each measure, item by item, explain to the parents if a child meets criteria for a diagnosis and why, and go over all my recommendations for their child. The recommendations are very specific to the needs of the child based on the results of the testing. Parents leave my office with a name, a number, and specific details about what other resources can help their child. I also provide 3 copies of the report to the parents as well as a PDF of the report.
You were a clinical psychologist at the Child Study Center before going into private practice full time. How has that shaped or influenced your practice?
I was at the Child Study Center for 5 ½ years where I completed my post doc training and then worked in the psychology department. CSC was an invaluable experience where I learned the highest standard of care for psychological testing and patient care. I was exposed to many different clinical populations including autism spectrum disorders, ADHD, intellectual disability, and learning disabilities. I had outstanding leadership and supervision, was trained on the ADOS (Autism Diagnostic Observation Scale), and was given the opportunity to evaluate over 900 children! I used these experiences and standards to help shape my private practice by carrying over the same high standards of care I learned. I am forever grateful for my experiences at CSC. What I love about my practice now, is that I have flexibility to spend lots of time with the families I serve; am constantly learning about new, wonderful referral resources for families (like Story Stage!); and am able to carry on relationships with families after the evaluation is complete to continue to offer resources and support.
It seems like so many more students struggle with anxiety these days. Do you see a lot of anxiety issues in your practice? How is it helpful to have an anxious child tested?
Unfortunately, I do see more anxiety these days as well. Our kids have so much on their plates these days- school, sports, friends, other extracurricular activities. If a child also has some other issue, like ADHD or a learning disability, it can all add up and just become overwhelming. Having an evaluation to see if your child is struggling with anxiety can be very helpful to help figure out what resources can best help your child. Remember that there are many different areas of specialty in the field of psychology. Some therapists specialize in depression, some specialize in trauma, and some specialize in anxiety. Figuring out what is causing your child's difficulty is important so that the right resources can be put into place.
What’s the best thing about your job?
Number one is helping wonderful families and working with their sweet kiddos! I love working with the kids, getting to know them and their families, and figuring out how best to help them. My work is very rewarding and I love my job! ☺
What’s the hardest thing about it?
Well, like every other job there are good things and bad things. I love working with the precious kiddos and I love meeting the families; but sometimes delivering the news of a difficult diagnosis can be hard. I am a mother too, so I can completely empathize with parents. But in a lot of cases, parents are relieved to know how to help their child. Families come to me for answers and help, and I try very hard to give them that in the most caring and nurturing way I can.
A Few Questions From Parents:
If my child ends up with an ADHD diagnosis, can you tell me if you think she needs medicine? Can you prescribe it?
I am not a medical doctor, so I cannot prescribe medication. I do however, let parents know when I think medication might be indicated and share that information with the child’s pediatrician (who is the one who will prescribe the medication). However, 9 times out of 10, I do not recommend medication right away because I like to try the “least invasive intervention possible." There are, of course, other cases where children have severe forms of ADHD and need medication due to safety issues or severe behavioral problems. In those cases, I assess each situation carefully to see if medication management is warranted.
My child was evaluated in his public school about a year ago, and diagnosed with a learning disability. He is still really struggling with friendships at school. Is this because of his learning disability? How might your evaluation help us?
Many learning disabilities, including ADHD, also cause social skills delays. So kids who have these diagnoses often struggle with friendships and social situations. If your child has already been evaluated one year ago, I typically do not think another evaluation is indicated. Often times, I will offer a free phone consultation to these families and give information on resources ...(like Story Stage!☺) that might help them with their social skills. However, if the previous evaluation did not address other concerns or new concerns have come up, a new evaluation might be recommended.
The school where my child goes thinks she might be autistic. Can’t my pediatrician diagnose that?
Typically, a pediatrician does not diagnose autism. Developmental pediatricians, who have received extra training on developmental disorders and delays like autism, can diagnose autism; but since there are so few of these type of doctors in the US, wait times to see one is long. A clinical child psychologist who specializes in assessing autism, (like me!☺ ) can assess and diagnose your child with autism. Due to my extensive training on autism spectrum disorder at the Child Study Center, this is an area that I am very experienced in. Wherever you go for an evaluation, be sure to ask if they use a ADOS-2 (Autism Diagnostic Observation Scale- 2nd Edition) in their assessment process. Many insurance companies will not accept a diagnosis (and therefore deny services related to the diagnosis) without an ADOS-2.
Thanks Dr. Chandler!!
The second post of this series can be found here.