Family counseling

Parents often have questions about how to raise their children.  “How do I set limits for my four year old?” “How can I encourage my teenage daughter when she refuses to study”. “My high schooler is confused which college she should apply to.” These family scenarios, though difficult, can be resolved if the right help is forthcoming. My meetings with families focus on practical strategies and ways to move forward so that each family member benefits. 

Individual educational, behavioral  and psychological assessment

Several factors contribute to a child’s refusal to perform in school or college. The child or youngster may have a specific learning difficulty, have a very short attention span, or may quickly forget concepts learned in school. Difficulty with academic learning is typically reflected in behaviors such as school avoidance, low motivation, distractibility, poor self esteem, and emotional outbursts.  Stress and anxiety impact learning in many ways. Psychological assessments are fine tuned to determine factors responsible for learning difficulty. My expertise and experience with children, adolescents and young adults ensures that they do not feel anxious about being assessed.  Every family leaves feeling their concerns have been addressed, and they have a path forward. After the assessment is completed, I present a report which is in line with best practices; each report has a detailed educational program and recommendations for school and home. The report also enables the individual to receive accommodations and exemptions (for example, exemption from a second or third language; or waiver from a course requirement) for high school and college. 

The Assessment Process

A battery of assessments is used to evaluate children from two years of age through young adulthood. Click the link here to read more about tests and reporting procedures.

I use a range of tests to measure behavior, academic learning, attention, language and other developmental concerns.  With my training and years of experience I always follow best assessment practices established by the American Psychological Association (APA). Given below is a brief description of some assessment measures that I use, and how they could help children succeed.

Tests to measure intellectual ability

  • The Wechsler Preschool and Primary Scale of Intelligence (WPPSI)  measures cognitive development for preschoolers and young children.
  • The Wechsler Intelligence Scale for Children (WISC) measures general intellectual ability for children between the ages of 6 to 16 years. It provides a full scale IQ score, and five primary index scores (i.e., Verbal Comprehension Index, Visual Spatial Index, Fluid Reasoning Index, Working Memory Index, and Processing Speed Index). Complementary subtests yield three complementary composite scores to measure related cognitive abilities relevant to assessment and identification of specific learning disabilities, particularly dyslexia and dyscalculia.
  • The Wechsler Adult Intelligence Scale (WAIS)  measures cognitive ability and intelligence in older adolescents and adults. It uses a core battery of ten  unique subtests that focus on four specific domains of intelligence: verbal comprehension, perceptual reasoning, working memory, and processing speed.
  • The Test of Nonverbal Intelligence (TONI) is both nonverbal and language free. It has no cultural bias and minimal motor requirements. It estimates intelligence by evaluating an individual’s ability to solve abstract/figural problems.

Tests to measure academic achievement (reading, writing, mathematics)

  • The Woodcock Johnson IV Tests of Achievement (WJ IV ACH) measure four curricular areas – reading, mathematics, written language, oral language  and academic knowledge. It is typically used to identify the presence of a specific learning disability.
  • The Brigance Inventory of Early Development is designed to provide information on how a child (between birth and age seven years) is performing in 5 key norm-referenced/standardized developmental areas: 1) Language Domain (receptive and expressive) 2) Motor Domain (gross motor and fine motor skills) 3) Academic-Cognitive (general/quantitative and pre-reading skills) 4) Daily Living Domain (self-help and prevocational) 5) Social-Emotional Domain (play skills and behavior and engagement/initiation skills).
  • The Gray Oral Reading Test measures oral reading rate, accuracy, fluency and comprehension. It is appropriate for individuals ages 6 years through 18 years 11 months. The GORT helps to a) identify those students who are significantly below their peers in oral reading proficiency; b) to aid in determining individual strengths and weaknesses in reading; c) to document student’s progress in reading as a consequence of special intervention programs.
  • The Test of Word Reading Efficiency (TOWRE) is a measure of an individual’s ability to pronounce printed words quickly and accurately (decoding and fluency). The test measures both the ability to sound out words and the ability to recognize sight words (sight word and phonemic decoding efficiency). The test can be used for individuals in the range of 6 years to 24 years. 
  • The Test of Written Language (TOWL) measures three components of written language- conventional, linguistic, and conceptual. It is appropriate for individuals 9 through 18 years of age. The test is useful in identifying individuals who write poorly and therefore need special help.
  • The Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI) is designed to assess the extent to which individuals can integrate their visual and motor abilities (eye-hand coordination). Three specific areas important to handwriting are assessed: Visual motor integration, visual perception and motor coordination. This screening test helps to identify children who struggle with copying, writing in the classroom, drawing, and may need special services. The test can be used for individuals between six to nineteen years of age.

Tests to measure attention deficit disorders

The Conners Comprehensive Behavior Rating Scales (Conners CBRS™) is designed to provide a complete overview of child and adolescent concerns and disorders. It is primarily used to assess children, adolescents, and adults with attention deficit disorders with hyperactivity, inattention, or a combination of the two. The questionnaires assess a wide spectrum of behaviors, emotions, academic, and social problems in today’s youth. Teachers and parents complete the paper-pencil questionnaire. Older individuals can use a “self-report” rating scale as well to reflect on their own behavior.

Brown ADD Rating Scales for Children, Adolescents and adults help assess executive functions associated with ADD/ADHD and related problems.

The Behavior Assessment Scale for Children (BASC) can be used by teachers, and parents to obtain a snapshot of behavioral and emotional functioning, quickly identifying children and adolescents aged 3 to 18 years who might be in need of additional support.

The Vineland Adaptive Behavior Scales (VABS) measures the domains of Communication, Daily Living Skills, Socialization, Motor Skills, and Maladaptive Behavior domains in children ages preschool through 18 years.

Tests for language disorders, including autism

Typically, a speech and language pathologist administers tests for identifying  language and speech delays. However, certain areas of language impact academic learning as well. Educational psychologists are trained to administer tests to measure language delays. It is important to understand that language here refers to the entire process of communication, language usage, and social interaction. Here are some tests that I administer:

  • Peabody Picture Vocabulary Test is an untimed test of receptive vocabulary.
  • PreSchool Language Scale is an interactive assessment of receptive and expressive language

Tests for autism and other communication disorders

  • The Childhood Autism Rating Scale (CARS)
  • The Gilliam Asperger’s Diagnostic Scale (GADS)
  • The Modified Checklist for Autism in Toddlers (M-CHAT)

Developmental delays: assessment and counseling

A developmental delay occurs when a child does not achieve developmental milestones within the normal age range. Simply put, it is a delay in a child's development. Delays can occur in one or more areas, for example, speech and language, motor skills, self help skills or adaptive skills, academic learning, intellectual delay and so on. When developmental delay is left unaddressed it could turn into a developmental disability, although the two terms are a little different. Parents often want to know which school program would best meet their child’s needs; or, what they can do at home to help their child. Dr. Nakra is able to provide educational and social programs to assist parents move ahead with the best program for their children.  

Counseling for Social and Emotional intelligence

Emotional and Social Intelligence refers to self-awareness, self-management, social awareness and relationship management, which enable people to understand and manage their own and others' emotions in social interactions. Casel (Collaborative for Academic, Social, and Emotional Learning) defines social and emotional learning as the process through which children and adults effectively apply the knowledge, attitudes, and skills necessary to understand and manage emotions, feel and show empathy for others, and establish positive relationships with family and friends. Dr. Nakra offers programs to assist with development of social and emotional skills, self-regulation and management of emotions to reduce anger, anxiety, depression, and stress in young children.