Hello, and welcome to another episode of The Testing Psychologist podcast. Good to be back, y’all. My gosh, it feels like it’s been a long time since the last episode and I guess it has been the longest gap in episodes since I started. That’s for sure. It’s been at least 4 or 5 weeks, which, as is the case in the summer, it feels like it’s gone by in the blink of an eye for a number of reasons. But I can say that I am really glad to be back talking with y’all. I’ve been thinking about the podcast. I have a lot of good ideas for interviews and topics coming up. So good to be back and [00:01:00] good to get back into it.
I got to say, over the last few weeks, I have certainly been busy. The summer is never as relaxed as I want it to be, but this summer I tried to prioritize some fun and engage in some business development as well and got to make both of those things happen right in a row toward the end of July. I think I mentioned this in the last episode, but I took a little vacation toward the end of July with friends to catch up with college buddies and it was incredible. It’s always really nice to get together with old friends. There’s nothing like it.
I had a good time there. And then almost immediately came back and turned around and traveled to upper Michigan where I got to spend a week with some [00:02:00] incredible people at a retreat or conference, I suppose led by Joe Sanok of Practice of the Practice. It was called Slow Down School. I’ve mentioned it before.
Slow Down School turned out to be an amazing experience. I connected with some awesome people who are doing really cool things here in the field with their practices and with consulting and also got a chance to unplug from everything here at the practice and here with The Testing Psychologist. It gave me, I think a lot of really nice perspective on where to take things going forward, how to rethink a few things here in the business and with consulting. So, totally worth it. I think that Joe plans to do it again next year. I would definitely recommend considering going to that if you are in the market for some [00:03:00] practice development.
Today, I am going to be talking a little about managing difficult behavior during testing.
When I was thinking about what kind of episode to do here this week, it just made sense to talk about difficult behavior during testing because I have had some really challenging kiddos here lately in the practice. Now, part of that, I should back up actually, part of what has happened this summer is we had some staffing changes, I suppose, and some gaps in our testing dates. So I have been doing a lot more testing than I usually do. Typically, I have psychometricians who do a lot of the testing, but I’ve been doing some testing and it’s been really cool in a lot of ways. I’ve likened it to coming out of retirement to play a sport you used to be really good at, but it’s amazing. It’s come back really [00:04:00] quickly. It’s been cool to interact with these kiddos for so long and get to immerse myself in the testing again. So that’s been cool.
The flip side of that, of course, is managing behavior during testing, which is not always great, particularly with the population of kiddos that I tend to work with. So, I thought I would talk a little bit about how I tend to manage difficult behavior and work with kids throughout the testing day.
One thing that I think about from the beginning is how to prepare kids for testing. This starts when I give parents an information sheet about the testing day. So that happens at the intake appointment before I’ve even met the kid.
I give parents an information sheet and it details the testing day, what the schedule will be, how to [00:05:00] prepare the kiddo for testing, and what to tell them, but it also goes into things like making sure that they sleep well the night before- don’t keep them up watching scary movies or anything like that. I make sure to have parents bring a water bottle and snacks for the kiddo.
And also just to make sure that the kiddo does not think that they are coming to an actual doctor’s office because I found that kids, for whatever reason, think that they are going to get shots when they go to the doctor’s office. And so I always tell parents very clearly to make sure their kid knows they’re not going to get any shots. We’re not going to do any needles or blood work or anything like that. So not that kind of doctor. So, a lot of it I think even starts with preparing parents and having them talk with the kid in a certain way about the testing process.
Parents often ask me, “What do I tell my kid about testing?”[00:06:00] I’ve come to recommend using a line like we are going to do some games and activities and some work to try and get a good idea of what your brain is up to so that we can help with blank. They can fill in the blanks with anything that the kid might be bought into in terms of things that they would like to be better.
For older kids, this might help with reading, help with friends, help paying attention in class, or help to make school easier. It could be anything like that. I tend to leave it pretty general and try to use whatever open door the kid may already have provided.
Usually, there is some buy-in from the kid’s side. Even if they’re defiant and they don’t necessarily love the idea of being here, usually, parents can identify [00:07:00] something to latch on to, something that the kid would like to improve or get better in their lives. I really like that line. We’re going to see what your brain is up to so we can help with blank and kids seem to latch on to that.
So, talking with parents is important. Making sure the kids are coming into the testing with hopefully decreased anxiety and knowing a little bit about what to expect. I think that goes a long way toward preventing difficult behavior in general. In some extreme cases like with kids who are super anxious or don’t want to be here for one reason or another, I’ve had parents bring them by two days early just to meet me, meet my assistants, and take a tour of the office so that it’s a little more familiar so that they know what to expect, and everything’s not brand new.
Now, on the day of [00:08:00] testing, I start right away, and this is just my style with kiddos. I greet the kid right away in the waiting room. I do so before I even talk to their parents. I’m pretty silly. If they’re having a snack, I’ll ask for some of their food, ask if they brought me something, or make a comment about their shirts or shoes or whatever. I have kids myself. At least at this point, I’m somewhat knowledgeable of cartoons and pop culture and that sort of thing. So, I can comment semi-intelligently on that sort of thing. So I’ll make a joke about that.
If it’s a teenager and I sense any sort of hesitation or defiance, which is common, to be honest, I will make a joke about it and say, I’m sure this is exactly what you want to be doing today, right? Or [00:09:00] this is going to be the best day of your life or something like that. I’m pretty sarcastic. And if I sense that a teenager might be able to get on board with that, then I’ll go for it.
With some, I might say, I don’t want to be here either. Man, we’re going to have a long day, so going overboard, playing it up, and disarming them a little bit, but yeah, anything you can do to build rapport. I’ll talk through the schedule again before taking the kiddo back to the testing room, just making sure they know that they can have breaks and drink water and get a lunch break and all that good stuff.
Once we get into the testing room, then I am again, pretty loose. I am very willing to, let’s say, stretch the standardization within reason, of course. I’m not doing [00:10:00] anything outside the bounds of ethics or anything like that, but stretch the standardization where, I’ll talk to the kid a lot before we even get started with testing asking about their lives, like what they did last night or that weekend, what they had for breakfast, what they like to do, just trying to get a sense of how they feel about being there and diving in trying to get a sense of what they expect and what they anticipate being easy or hard, what their parents told them about being there, if they know why they’re there, if it’s just a total mystery. So I’ll talk about all of those things in addition to the standard spiel about, we’re going to do a lot of different things today. Just try your best. Some things will be hard. Some things will be… I do all that of course, but I try to make as much conversation with kiddos as possible.
I show them around the room. They [00:11:00] often, especially if they’re younger, they’ll ask about everything that I have laid out for testing. And so I’ll let them explore. Often part of that is that I have little rewards and treats and a prize box and some balls to throw and little toys and things like that. So I’ll show them that stuff right away and let them know that, Hey, that’s there and we’ll get to take breaks later and we’ll get to play with that stuff. I just want you to do your best and you can get some time with these break materials later on.
Now, I let them know, of course, that they can take breaks whenever they want, they can go to the bathroom, they can get a snack, they can take a drink, they can get up and stretch, any of that kind of thing, just to make sure that they have a good idea of what to expect throughout the testing day.
For younger kids, we used to have a big whiteboard in the testing room that [00:12:00] we would do this on, but now I’ll do it on a sheet of paper, but I’ll draw a Candy Land type of map of the day’s activities, excuse me, a little scratchy voice, and on that map, I will draw out board game spaces with each space representing a subtest or maybe a group of subtests, and then I will put in break spaces every 3 or 4 spaces on the board and I’ll put in lunch and I’ll put in go home.
So this gives a pretty concrete representation again for younger kids of progress throughout the day. Kids always have some concern about when they’re going to be able to go home and that kind of thing. So, this just helps them know what to expect with the whole process. So, we’ll put a sticker over each space as they [00:13:00] progress and that helps show how they’re doing, how far we’re going, and how close we are to being done. And they seem to like that.
Reward-wise, I have no problem giving kids rewards throughout the day. So if they try hard, if they move through their board game spaces and get to their break spaces and they give a good effort, I have a box full of stuff that I bought from the dollar store, so just a ton of little simple toys and they get to pick little prizes for each break space that they get to. And they seem to like that.
Now, I’ll also break it up if I notice that kids are getting a little antsy. We’ll take breaks to throw a ball back and forth. I also like to take breaks to walk around the office. I call it adventure time. So I’ll ask, Hey, after this, do you want to go on a [00:14:00] little adventure around the office? They always say yes. So we go on an “adventure” to check the mail. We might look outside if there’s no, excuse me, squirrel running around or something like that. I also like those activities because tossing the ball or taking a walk around gives me a chance to informally assess gross motor skills, hand to eye coordination. I’ll also set it up where I have the kid lead us back to the office after our adventure. So get a little bit of a sense of how they navigate, a sense of direction, and that sort of thing. So that can be good qualitative info depending on your referral question.
Now, throughout the day, I’ll give them a lot of high fives, fist bumps, any sort of encouragement if they’re doing a good job, [00:15:00] just to try to keep them engaged as well.
Another thing that I like to do as we get moving through the testing and getting into the latter stages, particularly with the academic measures is, I will give them a choice in how they want to proceed.
Some of the testing has to happen somewhat in lockstep depending on what you’re assessing and the order you have to go in, but with academic skills, I tend to ask what they think is going to be the hardest and then make a joke about it throughout the day. Like, we’re going to do some math later and it is going to be super hard. Are you ready for some torture? Are you ready for some punishment? Just trying to build it up again and make a joke of it being super hard in hopes that it won’t be as hard as they think it [00:16:00] will be, but I will give them a choice of what they want to do.
So if we have reading or writing or math or whatever it might be, typically I’ll say, okay, here’s what we got and you get to choose which one you want to pick. Do you want to do the hard thing first and get out of the way, do you want to do something easy and build some confidence, or what? That just gives a little bit of choice again for how they engage in the testing, which I think helps quite a bit.
Now, two instances that have come up over the last few weeks with some of the kiddos, we’ve had some pretty sensitive, self-critical kids that got upset and melted down. They were crying. It was really hard. They were getting down on themselves about the work that they were doing. [00:17:00] So in those cases, I will break immediately after that subtest, and let them walk around, take some breaths, get a drink of water, throw the ball, talk to them about it like, Hey, is this familiar? Does this happen in school? Is this typically hard for you? Oh, I get it. You’re doing great. Just doing everything that we can to build them up. Sometimes we might have to text Mom or Dad just to get a little encouragement. They tend to like that pretty well.
In some cases, I’ve had 2 kids who, well, let me back up actually with the kiddos who had more emotional meltdowns in the room. It’s a good time to try to practice some breathing exercises or like get them doing some physical exercises to relax their muscles a little bit [00:18:00] and try to regulate them a bit. And that’s also, I think, good data to see how they can recover, engage in some self-regulation, and be flexible with their problem-solving. So try to do some of those exercises.
If they are super hyperactive, which happens, take more frequent breaks. Definitely up the rewards. I will talk with parents sometimes before the testing day, but sometimes this will happen during the testing day as well. I might text parents while the kiddo is doing a test or talk with them at lunch or something, but with the super hyperactive kids who tend to have ADHD, I’ll talk with them about rewards and can they try to play up a reward for after testing? And a lot of kids tend to respond well [00:19:00] to that. So even something like going to get ice cream or going to get lunch at their favorite spot, or sometimes parents will do a small toy. Of course, we can get into the pros and cons of reward-based behavior management, but for the testing day, that is something that we have utilized a lot just to try to keep kids focused and honed in.
In rare cases, I have let parents sit in the room while we at least get oriented to testing. They don’t sit in the room during the testing unless it’s called for in the standardization. But I have had parents, for example, sit within view out in the waiting area. So kids can look out the door if they need to. I’ve had some parents in extreme cases sit outside the door and we can peek our head out and check in with them if we need to, [00:20:00] if the kiddo is having a hard time.
The other day, I had a kiddo who was getting to the point of being somewhat unsafe. This kiddo was, let’s say very curious and very active and was bouncing around the office to the degree that she almost pulled a lamp down on herself. I don’t think it would have been that dangerous, to be honest. Our lamps are not heavy or anything like that. They’re pretty kid-friendly. Either way, she was getting close to damaging something.
And so in that case, rather than stay seated at the desk and try to call her back, I had to get up, walk over, did the hey, look at me, let me have your eyes. Let’s [00:21:00] talk about what’s going on right now. Let me keep you safe. I have to keep you safe. Here’s what that means.
That’s about as far as I would go in terms of I guess you would say behavior management techniques. I’m a big fan of whole brain child, no drama discipline, that kind of thing where you make sure you have the kiddo’s attention and talk them through what might be going on and try to anticipate what they’re needing and give them some space to articulate that.
After that, we ended up taking a walk and we did some cool things to make her chair a little bit more fun. We got a stuffed animal that she could hold in the chair, little things like that to try and help her regulate and stay seated.
Now, I will let kids stand up and move around the room if they need to. There are a few tests where I think this is not a problem at all, like vocabulary [00:22:00] and similarities. If kids can pay attention, they can even do it during digit span or some of the listening comprehension tests. I mean, standing at the table. I’m fine with moving around. I am fine with it as long as it’s not super disruptive. So try to be cognizant of the fact that it’s hard for kiddos to sit still for too long. And so, we’re taking breaks as much as we can and moving around as much as we can.
And then I think ultimately, in my case, the worst-case scenario is to reschedule testing for another day. We tend to knock out testing in one day for the most part, but there are some cases when that is not possible and it’s clear that it’s affecting the testing process and the validity and you’re just not getting good data. So I think that’s a piece that develops just from clinical experience and being able to gauge how kids are [00:23:00] doing and if they’re attentive or not. But if I find that they’re just not into it and they’re totally losing concentration, we will just set up testing for another day.
In some cases, we can break it up a little bit. If I can do a personality measure with the kiddo and let them answer questions on the computer for a little bit to cut down on the brain drain of the cognitive activities, sometimes that can help and we can return and finish. But in some cases, we reschedule testing for a different day and that’s totally okay too.
Those are some of my thoughts about managing difficult behavior during the testing day. Like I said, that’s pretty relevant for me here lately, so I got to thinking about it and also realized, at least for me, we didn’t get a whole lot of training with that in graduate school. We got a ton of training around how to administer the assessments and score and write them up, but [00:24:00] if you’re working with kids, there are a lot of considerations for managing difficult behavior.
I hope you are able to take some things away from this. I would love to hear some ideas, strategies, and things that others of you might use. You can always email me. My email address is jeremy@thetestingpsychologist.com.
This would also be a great discussion for our Facebook group which is The Testing Psychologist Community. You can find that by searching on Facebook for The Testing Psychologist Community. We have a lot of good discussions in there about various testing topics and things that come up during testing, measures, strategies, marketing, and all sorts of things. So, if you have thoughts on this particular topic or anything else testing-related, come check out the Facebook group.
[00:25:00] The website as always is a great resource; thetestingpsychologist.com. You can find past podcast episodes. You can find information about consulting on testing if you are interested in growing testing services in your practice or adding clinicians to your practice who might be able to do testing and add that additional service area. So lots of resources for you.As always, I appreciate the listening. It’s been cool to see this audience continue to grow and find that this is a valuable service and source of information for folks. It’s awesome. I love talking about this stuff. It’s great to be back.
Like I said, in the beginning, I do have some cool topics coming up and some great ideas for interviews that I hope will come to fruition. So hope to be doing some episodes on report writing, specific [00:26:00] batteries for particular presenting concerns. I would love to talk with someone about assessment with older adults because I tend to focus a lot on kids just because that’s what I do and maybe even talk more about hiring and training psychometricians. Folks seem to be very interested in that process.
I’m also going to be adding some episodes and some resources for master’s level clinicians who may own practices and want to add testing folks to their practice, even though they might not be doing it themselves. So we’ll be focusing more on some of the pure business strategies and hiring testing folks as well going forward. So glad to be back. I will look forward to talking with you next week. Take care in the meantime. Enjoy these last few days of summer. I’ll talk to you later. Bye [00:27:00] bye.