Does my child need a psychological assessment?

Almost nobody arrives having decided their child needs assessing. They arrive with a nagging feeling they have been carrying for a year.

The most common version is a gap between effort and outcome. A child who is clearly trying — sitting down, doing the work, being tutored — and still not getting there. A child who understands something perfectly when you explain it out loud and cannot produce it on paper. Reading that has stayed slow and effortful long after classmates stopped sounding words out.

Another version is a change. A child who was fine and is not now. School refusal that started as a stomach ache. A quiet child who has become angry, or a lively one who has gone quiet. Sleep that has broken. Friendships that have thinned out.

And a third is being told. The school has raised it, gently or otherwise, and asked you to "get him looked at" — and you are somewhere between defensive and frightened and not sure which of those is fair.

Parents also describe the thing that stops them, which is almost always the same: the worry that an assessment will attach something to their child permanently.

Nothing in this article is a checklist and there is nothing here to score. Recognising your child in a paragraph does not mean anything is wrong, and not recognising them does not mean nothing is. Only a qualified clinician can tell you what is going on.

It is not one test. Which ones are used depends entirely on what is going on, and that decision is clinical.

Learning and achievement assessment looks at reading, writing, spelling and number against what would be expected for that age — the route into specific learning difficulties including dyslexia and dysgraphia.

Cognitive or IQ assessment looks at reasoning, memory, processing speed and comprehension. It is often the piece that explains a puzzling profile: why a bright child produces poor work.

Neurodevelopmental assessment is the structured route for ADHD and autism, drawing on direct testing, developmental history and information from school.

Emotional assessment and symptom screening looks at mood, anxiety and how the child is coping, which matters because distress and learning difficulty imitate one another constantly.

Both are asked constantly and both have the same answer: ask rather than assume.

Very young children can be assessed, though what is used differs — for a child under seven the work is often play-based rather than paper-based, because a five-year-old cannot sit a written test or narrate their own difficulty. Some things are better waited on, and if that is the case for your child a clinician will tell you so rather than test them anyway.

At the other end, teenagers and adults are assessed regularly, often for the first time, and a diagnosis that arrives at sixteen or at thirty still changes what somebody understands about themselves and what support they can ask for. Late is not the same as pointless.