Identifying, Assessing, and Treating Early Onset Schizophrenia at School by Huijun Li & Shane R. Jimerson & Melissa Pearrow

Author:Huijun Li & Shane R. Jimerson & Melissa Pearrow
Language: eng
Format: mobi
Tags: Reference & Language, Springer, Psychology, Health & Well Being, Child Development, Child & Adolescent, Nonfiction, Education & Teaching
ISBN: 9781441962720
Publisher: Springer
Published: 2010-09-01T21:00:00+00:00

Testing Considerations, Accommodations, and Modifications

81

Considerations Based on the Subtype

Schizophrenia is not a unidimensional diagnosis and the various subtypes – paranoid,

catatonic, disorganized, undifferentiated, residual – can present very differently in a

psychoeducational evaluation. For example, a student with the paranoid type of EOS

may demonstrate adequate cognitive functioning and lack disorganized speech or

inappropriate affect, but demonstrate prominent delusions or auditory hallucinations of

a persecutory or grandiose nature (APA, 2000). In contrast, a student with the disorga-

nized type of EOS may present with disorganized speech, total incoherence, neologisms

(nonsense words), or echolalia accompanied by physically disorganized behavior such

as repetitive purposeless activity, odd posturing, or disruption in the ability to perform

activities of daily living, such as showering or dressing (APA, 2000).

When planning the psychoeducational evaluation, it can be helpful to have as much

information about the EOS psychiatric diagnosis and subtype to plan for the necessary

modifications and accommodations. For example, when assessing students with gross

and pervasive disorganization, it can be helpful to start with tasks that have strict stan-

dardization procedures and are highly structured (e.g., cognitive and achievement

testing). These students may have difficulty engaging in verbally-laden tasks, thus

requiring the assessment to focus on nonverbal processing skills. Students who are

paranoid, however, might need to be given choices on the organization of the tasks

with constant transparency about the process. For example, it could be disturbing for

a student with paranoia to have an examiner sit with a clipboard taking notes. Rather,

the examiner can share with the student the activities that need to be accomplished, the

notes and information being recorded, and frequent updates on the assessment process.

For those with catatonic inhibition (e.g., decreased activity level, limited speech), the

examiner may need to provide opportunities for the students to communicate in writ-

ing or by drawing the responses. In all of these examples, behavioral observations and

copious notes are critical components of the evaluation as they document the modifica-

tions of standardized procedures necessary for completion of the assessment.

Considerations Based on the Phase

The phase of the illness (active, recovery, residual) is also important to consider

when designing a psychoeducational evaluation of a student with EOS. Students

who are in the recovery or residual phase of their illness may be able to provide

accurate information about their history, current experiences, and treatment. They

may also be able to discuss the challenges they are experiencing in the school

setting, thus requiring few or no specific modifications or accommodations. If they

are in the active phase, however, they may not be able to provide accurate informa-

tion and the evaluation will need to be greatly modified to obtain their mental status

(Fontaine, 2009). In these cases, the school will instead need to assist the caregivers

as they obtain medical and psychiatric evaluations to ascertain the student’s level of

safety while also creating an intervention plan.

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