Among school psychologists’ most important tasks is conveying assessment findings. In large part, school psychologists make their living by way of communication, including communication of assessment findings. It’s sometimes easy to forget the obvious. School psychologists do not manufacture a product like an industrial worker, they do not systematically engender reading or math skills in pupils like a teacher, they do not avert or correct illness like a healthcare worker, and they do not devise plans to build something valuable like an engineer. Instead, they often size up and make sense out of students’ problems. This is an important undertaking because it assists teachers and parents in understanding, supporting, and correcting difficulties. Meaningful assistance happens, however, only with clear communication.

There are also unavoidable obligations when students are assessed. At the conclusion of the process, school psychologists are obligated to share findings with parents. This is true regarding ethical guidance from both NASP and APA. According to NASP Principles of Professional Ethics (2020) Standard II.3.11 “School psychologists adequately interpret findings and present results in clear terms. They ensure that recipients understand assessment results so they can make informed choices.” Similarly, according to the Ethical Principles of Psychologists and Code of Conduct (APA, 2016). 9.09 “Psychologists retain responsibility for the appropriate application, interpretation, and use of assessment instruments, whether they score and interpret such tests themselves or use automated or other services.” The same Principles in section 9.10 indicate that “…. psychologists take reasonable steps to ensure that explanations of results are given to the individual or designated representative….”

Verbal feedback satisfies these ethical requirements. But if there is a written report (which almost always exists) parents will also be able to access it. Broadly speaking, the two principal vehicles for communication are orally and in writing. We cover post-assessment oral communication in this chapter. Preparation of written reports is covered in the next (Chapter 14).

The Parent only Feedback Session

There are several ways in which oral feedback can happen. Let’s start by looking at the simplest variant, the feedback session. In its standard form, as routinely practiced by clinical psychologists, neuropsychologists, and counseling psychologists, it involves sharing information  directly with parents (and potentially the student). A typical scenario involves a child with a potential social-emotional problem seen in a clinic or private office. As you learned in Chapter 3, a referral question would have been mutually agreed upon before assessment commences. Logically then, that same referral question is unequivocally answered during a face-to-face feedback session. In other words, the assessment process is launched by a question and wrapped up with (oral) answers to that very question. Although this sounds simple, often it is not.

These feedback sessions are inherently complicated and fraught with potential missteps. There are many considerations for post-assessment sessions as practiced in clinics (and sometimes) in schools. Regarding potential problems and ways to avoid them, Tharinger and colleagues (2008) presented detailed considerations that they gleaned from the professional literature. Happily, these comprise a list of ideas psychologists might keep in mind to enable an ethical and effective feedback session. Included are the following:

• restate the purpose for assessment at the outset of the feedback session
• convey only the most pertinent assessment findings
• balance unpleasant findings with information about the child’s strengths
• speak in clear, common language (not jargon, not with too many numbers)
• be concise
• adapt to parents’ cognitive level
• attend to parents’ mental health
• attend to potential parental feelings of guilt and responsibility
• avoid recommendations that may prove too demanding of parents
• evaluate the parents’ understanding during the session

Others have referenced similar themes, including encouraging parents to openly voice their own concerns and to freely pose questions (Pruett, 2013). Similarly, parents often want to hear a review of the  assessment process and hope that diagnosticians recognize that an assessment of their son or daughter often comes with an emotional reaction (and an accompanying need for support). This is apt to be particularly true when a diagnosis like autism is made (Abbott, Bernard & Forge, 2012).

It is easy to see that parental feedback is not only important, its delivery is also daunting. Consequently, novice psychologists often feel anxious about their capabilities and uncertain about how to proceed. These are skills that are hard to learn. Some of the barriers to learning  might arise from the nature of feedback sessions themselves—executed in private and without a detailed, reviewable record. In other words, psychologists meet with parents face-to-face, provide feedback, and then go on to the next case. Consequently, their precise words and even their preferred style is rarely available for colleagues to critique. Equally constraining, one psychologist has no access to what other psychologists do during their feedback sessions. In some ways, they are flying blind. Contrast oral reporting with written reporting. In reality, most practicing psychologists have read many, many of their colleagues’ written reports. The relatively public nature of written documents permits school psychologists to mirror others’ writing style, replicate their format and parallel their insights. If you are a student, your supervisor may sit in on one or two feedback sessions before you are on your own. This is too little guidance to advance the skills needed for a good feedback session. As you will see in Figure  13.1, a checklist created from some of the points raised above may assist you in bending the arc of your oral skill development in an upward direction.

But when might school psychologists conduct feedback sessions akin to those of a clinic-based counterpart? For some school psychologists, such as those restricted to a gatekeeping role, the answer may be quite rarely (or even never). For others, such as those who engage mental health questions and provide mental health services rather than just gatekeeping, the answer may be somewhat frequently. Returning again to Table 3.1, referral questions #1, 2, 7, and 8 might involve traditional post-assessment feedback sessions. In contrast, other referral questions, such as those that involve special education eligibility (i.e., #10-13), may not.

The Parent only Feedback Session as a Prelude to a Full Eligibility Meeting

Often, of course, school psychologists’ referral questions concern special education eligibility or Section 504 entitlement (referral questions #10-13 in Table 3.1). Many times, but not always, there is a single on-campus eligibility meeting encompassing assorted individuals, not just one psychologist, sharing assessment information with parents. Because this meeting is charged with establishing formal eligibility it is inherently different than a clinic-style feedback session. It is quasi-legal, and it concerns satisfying eligibility criteria (as covered extensively in Chapter 10). The trouble is that parents may need to be told sensitive assessment results and confronted with potentially disquieting conclusions during a rather public meeting. School psychologists often have a lot of information to convey during a team eligibility meeting. The same might be true of other diagnosticians (e.g., occupational therapists, speech-language pathologists).

Thus, some school psychologists conclude that there is simply too much psychological information to share during a compressed eligibility meeting. Furthermore, some school psychologists anticipate that touchy subjects will arise, and these will prove too sensitive to handle adequately with a large group present. Consequently, some school psychologists schedule pre-team eligibility meetings during which only parents are present. Under these circumstances, the school psychologist later attends a formal eligibility meeting with her professional colleagues and the student’s parents. Envision a situation, for example, where assessment findings point toward autism or intellectual disability (ID). The volume of information shared to confirm eligibility for either autism or ID, coupled with the  delicate nature of this information, prompts many school psychologists toward a preliminary meeting. In fact, researchers found that approximately three-quarters of school psychologists would hold a one-on-one preliminary meeting (i.e., about the presence of a developmental disability) in advance of a group meeting (Wodrich, Tarbox, Balles & Gorin, 2010). This same practice might also be true of various social-emotional assessment findings. For example, a situation with the same need for a “pre-meeting” might concern a student with severe OCD who is ultimately destined for ED designation.

What is the nature of a parent-only feedback meeting? Although variability is likely common, a meeting like this might represent a hybrid of the traditional, clinic-based approach covered above and the quasi-legal, eligibility determination meeting described in the next section below. The points made by Tharinger and colleagues likely still apply, but rules for special education eligibility warrant attention (as do programming options if eligibility is later established formally). Many school psychologists seem to learn that a preliminary meeting allows them latitude lacking in a team eligibility meeting. This is particularly true for parents who are easily confused, those that require convincing, or those that seek details. For these parents, a so-called “bottom-up” explanatory approach might be advisable (see Wodrich & Schmitt, 2006).

The bottom-up approach comprises feedback presented one detail at a time. It involves a presentation characterized by: fact, fact, fact, fact, finally followed by a fact-congruent conclusion. This approach allows a central conclusion (e.g., a particular diagnosis, a special explanation for a presenting problem) to become progressively clearer so that it is ultimately grasped and accepted as credible. Correspondingly, the bottom-up approach represents an antidote to prospective parental confusion on the one hand and parental disagreement on the other hand. In other words, when parents are confused about the nature of your assessment process or doubt your conscientiousness, thoroughness or impartiality, then your findings are in jeopardy. The rationale is that the bottom-up approach often solves these problems. Its essence is details presented patiently and clearly. This approach helps parents understand the psychologists’ assessment process; it coincidentally teaches them about the nature of the diagnosis or explanation under consideration. The school psychologist checks at each stage to make sure parents understand. Typically, bottom-up explanations concern a discrete diagnosis (e.g., like Breanna’s depression in Chapter 7). Although sometimes well suited to parents’ needs, the bottom-up approach is generally too tedious, too time consuming, and too psychologically-focused for the type of group (team) meetings that concern special education eligibility. Illustration 13.1 demonstrates the bottom-up approach as it unspools when parents of an elementary student named Zach Long meet alone with a school psychologist to hear about their son’s possible ADHD. This meeting, as we will soon see, can occur when special education issues are destined to be discussed in a later meeting. Incidentally, Zach’s case could realistically occur in a state like Arizona, which now authorizes certified school psychologist to confirm the presence of ADHD when OHI services are at issue. As you read Illustration 13.1, you might ask yourself how well the bottom-up approach might work if this were a meeting with an entire team, not just Zach’s parents.

Of course, there is a counterpart and contrasting approach that has been entitled the top-down approach (Wodrich & Schmitt, 2006). As seen in Illustration 13.2, illustrative of the top-down approach Zach’s parents receive the big picture first, followed by some details coupled with plenty of time for clarification and planning. As you might suspect, in reality, most meetings reflect their own unique blend of bottom-up and top-down elements. That said, it is helpful to contemplate the best style that would match the particulars of each meeting you conduct. Sometimes school psychologists (provided they are versed in both contrasting approaches) even offer parents the choice of styles at the outset of parent-only feedback sessions. Accordingly, a school psychologist might say something like this: “As you know, we are meeting to talk about your daughter’s evaluation results. I want to be responsive to your needs. There are a couple options for you to consider. First option: I can offer you the big picture followed by details that led me to my conclusions. A second option is more or less the opposite approach. I could offer you details of the assessment and things like scores, one at a time. At the end, I would give you my conclusion and recommendations. Either way, we’ll save time at the end of our hour together to talk things over, for me to answer questions, and for us to discuss what this all means.” A warning, especially to beginning school psychologists, is in order. If you offer parents options, be certain in advance that you can live with either style that they might select.

Now you will see a contrasting approach (one that is top-down) in Illustration 13.2. This approach kicks off with a big picture conclusion and then fills in, as needed, with assessment-related details. Note the distribution of time within this meeting and the relatively brief time deployed to explain assessment findings per se.

The Special Education Team Eligibility Meeting

Some ideas well suited to parent-only meetings (except the bottom-up approach) might also fit group eligibility meetings. But the latter type of meetings have a crucial purpose that is distinct from (or sometimes complementary to) a parent-only feedback conference. This is because team eligibility meetings are necessarily quasi-legal. They are mandated before students access entitled services (or protection from discrimination, in the case of 504 Plans). These considerations are not true of generic feedback meetings. Anyone who doubts the quasi-legal nature of eligibility meetings should consider their extensive paperwork. Associated with eligibility meetings, parents are given advanced notice, they are told about their rights to contest findings, they are required to sign extensive paperwork enrolling a student in services and sanctifying those services in the form of an IEP.

What’s more, these meetings involved several individuals besides the evaluating school psychologist themself (i.e., they are “team” meetings). Minimally, the student’s current teacher, a special educator in the area of potential disability, an administrator, the school psychologist and parent/ guardian attend. When evaluations are conducted by allied professionals (e.g., speech-language pathologist, occupational therapist) the numbers can swell. Add a school nurse if there are prospective health considerations and potentially even an outside advocate if parents anticipate a dispute, and the count grows still further. Under these circumstances, the risk is that team eligibility meetings become lengthy, drift off topic, or devolve into contentiousness.

It also seems true that parents are apt to become bewildered by the arcane rules surrounding eligibility and by eligibility meetings’ ritualized nature. At least this is implied by findings from small-scale studies of parents’ perceptions of the eligibility process. For example, parents in a study conducted by Zeitlin and Curic (2014) felt that meetings were depersonalized, excessively focused on paperwork, and short on cooperation between themselves as parents and the school’s eligibility team members. In another study on the same topic, parents’ expectations failed to match the quasi-legal nature of the actual meeting (Canary & Cantu, 2012). It was as if two distinct cultural perspectives were clashing. This study also found an emphasis on the technical (e.g., recounting of test findings), too little time to cover procedures in depth, and extensive paperwork (i.e., obligation to process forms). Anyone who has attended more than a few eligibility team meetings is likely to recognize these themes. Most witnesses to the process can recount at least one “horror story” concerning a meeting that seemed to go on without end. The meeting might have witnessed the same topic visited and then revisited again and again, only to adjourn without ever achieving a resolution. What can school psychologists do to make the eligibility meeting process more humane and more effective?

Managing Eligibility Meetings

Here are some suggestions especially pertinent when a meeting’s topic is special education eligibility. They assume that school psychologists lead the meeting, although in some districts that role routinely goes to an administrator.

Set Expectations at the Outset

Simply put, a school psychologist say something like the following to all of those present: “We are here to get feedback on the evaluation that was just completed. With that feedback, we can decide if Maria is eligible for special education. If she is eligible, we can also decide what services to provide. As we move toward a decision, we have a checklist to guide us about eligibility. We have one hour in which to finish the meeting.”

Reset Expectations

If the team begins to spend too much time on topics tangential to eligibility, redirection may be needed. The following might be said, for example, to a parent who dwelling on past grievances: “Even though it was unfortunate that Maria’s second grade teacher might not have managed her behavior in the way that you wished, we need to go back to our task. Maria is now in the fifth grade and is encountering significant school problems. I’d like to get us all back to the topic of judging eligibility and making a plan for special education services. To do that we must determine if Maria has an educational disability.”

Watch Out for the Substitution Heuristic

At their core, eligibility questions involve satisfying a set of objective criteria (as you saw in Chapter 10). Each eligibility question, for each individual student, is a multi-faceted consideration that requires deliberate analysis and reflection. None should be made via snap judgements, subjective impressions, or wobbly logic. Unfortunately, humans are prone to decision making errors. Some of these are heuristics, mental shortcuts that lead to faulty conclusions as you saw in Chapter 2 (Kahneman, 2011). A prime example concerning eligibility determinations is the substitution heuristic. As you may recall, the substitution heuristic occurs when we unconsciously substitute a simple question for a complex one; answering the first question (the simple one), we may mistakenly conclude that we have answered the second question (the complex one). In an eligibility team meeting the substitution heuristic might take this form. A simple question before the team: “Would Maria benefit from resource help?” (i.e., a simple question that lends itself to intuition) gets substituted for a complex question that requires reflection and analysis, which is “Does Maria meet all necessary emotional disability criteria?” Once again, keeping eligibility criteria handy or working off of a checklist of eligibility criteria can prevent emergence of this troublesome heuristic (see the Checklist for Emotional Disturbance Qualification, Chapter 10).

Set and Adhere to Reasonable Timelines

It is interesting, and instructive, that the U.S. Supreme Court strictly limits oral arguments. Each Supreme Court case permits just 60 minutes of oral argument in total, 30 minutes for each side. And, of course, the Supreme Court renders the most consequential imaginable decisions. Should special education deliberations require more discussion than that afforded in our nation’s highest court? It’s hard to imagine they should. Consider notifying all attendees at the outset how much meeting time is available. Then be prepared to summarily wrap up the meeting (including eligibility judgments) before the sands of your hourglass have disappeared.

Write a One-page Summary to Prepare for an Oral Presentation

Regardless of your audience, your oral explanation needs to be clear and concise. Consider the following recommendation: write a single page document for parents that “includes a very brief summary of findings, bullet-points, diagnoses, and recommendations…it is also an excellent way…to clarify and organize thinking prior to sitting down with families (Postal & Armstrong, 2013, p. 269). Parents might read this in advance of an eligibility meeting (in concert with, or in lieu of, a parent-only feedback session). A drastically brief document forces its author to prepare a written variant of the 3-minute elevator speech (i.e., the type of speech in which the essence of a business proposal or a dissertation must be delivered simply and rapidly). There is room for nothing more than key points. If you prepare a letter, you might hold onto if during a feedback session with parents, when meeting with the students personally as well as during an eligibility meetings. Preparation of a one-page letter can promote clarity and conciseness, whether you glance at it during a meeting or recall its gist from memory as you speak with your audience. That said, it may prove utterly impractical to prepare a separate written summary for each parent. Most school psychologists are already overwhelmingly busy. However, the practice of doing so, even if only mentally, can prove to be an aid to concise thinking.

What about Oral Feedback for the Student?

All of the types of meetings mentioned above (e.g., parent-only feedback, eligibility meetings) concern primarily adult stakeholders. But what should you do to address the needs of the students themselves? Clinic-based psychologists seem at least somewhat equivocal about sharing assessment findings with children/teens. Logistical considerations may prompt questions about how to proceed. Is another clinic appointment needed to speak with the child? Should some of the office time allocated for parental feedback go to the youngster? Might it be best to have the children sit in for an entire feedback session if they have accompanied parents to their appointment? Fortunately, fewer logistical challenges exist in schools. Moreover, NASP professional standards (2020) imply that students should hear about findings (i.e., there is a requirement that students participate in decision-making). Sometimes, however, students themselves may be less interested than parents in hearing about assessment results. In addition, pre-teens may need especially simplified explanations. Even many adolescents will require quite uncomplicated explanations for the rationale behind their assessment, its essential findings, and what it means for short-term interventions and long-term potential needs. For these reasons, it is often helpful to meet with each student individually. Such meetings can be calibrated to a student’s personal level of understanding and interest. Meeting face-to-face with just the student can sometimes also help to debunk myths while simultaneously setting the stage for interventions (e.g., special services). With relatively unfettered on-campus accessibility, students might also be encouraged to return to the school psychologist if new assessment-related questions or concerns arise.

This topic begs the question about potential disclosure-related harm. In other words, might sharing findings cause the student psychological distress or set in motion counterproductive changes in self-perception? Perhaps. Josh, a 17-year-old high school student, had long thought that his problems in high school were due to test anxiety. He complained to his guidance counselor and his parents of seeming to go blank when confronted with school exams and especially in the face of high-stakes tests. A comprehensive psychoeducational evaluation produced findings that altered Josh’s self-conception. Measures of general cognitive ability placed him only slightly above average while revealing mild problems with long-term memory. In contrast to Josh’s preconceptions, there were only mild indications of anxiety generally (determined via rating scales and self-report measures). Even more critically, a detailed clinical interview suggested that anxiety reactions during testing were probably a consequence, rather than a cause, of poor test performance. Josh was indeed pained when he learned about the level of his cognitive scores. More broadly, he was left with a different conception of himself as a student, one that was arguably more negative.

Constance is a petite 7-year-old girl who has routinely been described by her family as “marching to the beat of her own drummer.” Her educational history includes strong academics but weak interpersonal skills and mild quirks (e.g., wearing exactly the same style and color of cotton dress every school day). Her parents fully embrace Constance’s uniqueness while recognizing that it imposes long-term challenges for her personal adjustment and ultimate happiness. Thus, they were only mildly surprised when they heard that their daughter met criteria for Autism Spectrum Disorder. Constance herself seemed indifferent when she met with the school psychologist to hear about the results of her evaluation. In the weeks the followed, she rarely (if ever) thought about what her diagnostician had told her.

Jamal’s grades have cratered now that he is a high school freshman. He presently completes little schoolwork. Even more obvious, and more troubling, are a series of emotional outbursts during and between classes. Jamal comes from a military family, and both of his parents have attributed his always turbulent temperament to frequent moves and recurrent demands to adjust to a novel school and make another set of friends. Now his father is convinced that Josh’s “new attitude” represents blatant defiance of parental authority aggravated by poor sleep habits and selection of a band of friends best described as shady. A detailed evaluation, however, determined that Jamal is, like three close relatives, an individual with bipolar disorder. Learning that there are treatment options available outside of school plus educational options within it, Jamal’s parents relaxed and for the first time in many years thought optimistically about their son’s future. More importantly, Jamal’s sense of himself had changed. He was no longer puzzled by his mood swings (especially irritability) and he had stopped blaming himself over and over for poor emotional regulation. In addition, he is now better able to understand why sleep often proves so elusive and why he is sometimes plagued by racing thoughts.

Let’s think about these three thumbnail examples. Josh’s case seems to exemplify an unfavorable consequence of providing a student with post-assessment feedback. Constance’s case, however, seems to imply that sometimes feedback is largely inconsequential. But Jamal’s case brings up another possibility. It can be argued that going through an assessment process and receiving feedback about its findings (including a label) was beneficial. Consistent with the gist of Jamal’s case, trainers in child psychiatry sometimes contend that social-emotional assessments themselves (even before the launch of any interventions) turn out to be surprisingly therapeutic (Pruett, 2013). The very same contention is sometimes made by psychologists who champion detailed post-assessment information sharing. In their book describing the relevance and the particular methodology for providing assessment results, Postal and Armstrong (2013) include a chapter provocatively entitled “Providing the Correct Label Can be Therapeutic.”

It doesn’t take much imagination to envision optimism and relief among Jamal and his family after learning about his diagnosis and processing what it means for making sense of his disconcerting and perplexing array of behaviors. Such a meeting might reasonably be expected to remove the mystery surrounding Josh’s longstanding (and recently deteriorating) emotional state. Labels, although clearly capable of harm, can also promulgate good (see Chapter 1 for more discussion on labels in the assessment process). But once again, it’s not just about the potential utility of information sharing with stakeholders (including minors). Regardless of whether feedback with a student might be harmful (Josh), inconsequential (Constance), or potentially beneficial (Jamal), students still possess a right to know within the scope of their developmental level. For these reasons, psychologists often propose every child, or nearly every child, receive direct feedback (Dombrowki, 2020; Frick, Barry & Kamphaus, 2020).

Summary

The successful practice of school psychology rests nearly entirely on effective communication. And, there is no more vital information to communicate than assessment findings. When teachers and parents pose questions about behavior, adjustment and social-emotional functioning, school psychologists strive to answer clearly, concisely, and compassionately. They may do so orally or in writing. Among important considerations for oral communication with parents are the following: concentration on pertinent details only, use of everyday language, plus recognition that parents may harbor feelings of guilt or struggle with their own findings-related emotions. When special education is at issue, and meetings involve a team, oral communication must take on a quasi-legal focus. Checklists can help school psychologists to make correct judgments about eligibility as they avoid troublesome heuristics.