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Test child, real child.

The child being evaluated can't jump over an eraser on the floor and clings to his mother's hand. The real child, at home, hops down a line of six laundry baskets, slowly but gleefully.

The child being evaluated can barely totter up a few stairs holding an adult's hand, putting both feet on each tread. The real child climbs stairs well, if slowly, by himself, one foot per tread, sometimes skipping a tread.

The child being evaluated can't stand on one foot. The real child hops all the way down the hall on one foot.

The child being evaluated swipes at the blocks on the table, almost knocking them off. He can't concentrate on a task, the examiner says. He has a short attention span, poor impulse control. We might as well quit the session, the examiner says. The real child gives me a wicked, sidelong look; he calculated that swipe precisely so that no block actually falls off the table -- he knows his limits with me, as well as with the examiner. He has achieved his goal of making the examiner quit, something he'd been working on for the whole session.

Back home, the real child constructs a complicated pattern of mosaic tiles in a hexagonal frame, tongue locked in his teeth as he centrates on following the pattern on the box. It takes him a long time, but he gets it right. He reads a new book, struggling but triumphant. He works at doing a skin-the-cat, again and again, until he can land on his feet.

The examiner, shown a videotape of the real child hopping through the laundry baskets, swinging on monkey bars, climbing a gate, playing the piano, reading a book, wallowing happily on his father, comments that he "shouldn't" be that different at home than at the medical center. The real child, watching the examiner watch the tape, stands on one leg and gives me a dirty look. "You blew my cover," that look says. He puts his fingers back in his mouth, trembles, looks pale, wan and hopeless. The examiner shakes her head, confused, but soon comes back to her original decision. He makes that easy with his vacant expression.

Six months after the evaluation, the real child admits (now that he has more language skills) that he was bored, didn't like the examiner, and was "bad" on purpose. All that falling off his chair, all that squirming, all that refusal to make eye contact or pay attention, all those hasty answers: all his way of saying (since he couldn't say it in words) "I don't want to be here; I hate this; I don't like this person; this is boring; when are you going to let me get out of this place?"

This is not the first examiner to be frustrated or fooled by his unwillingness to put up with test situations. He never liked the informal testing that family and friends tried to do -- faced with a demand to perform, he withdrew instantly, though he would display his skills readily if allowed to do so at his own pace. In formal situations, once he realized that he would not be told if his answer was right, and

not be allowed to learn from mistakes, he turned against the whole procedure. Saying "Good guess" for each answer doesn't reinforce him; it upsets him. He knows what guesses are: they're wrong, and he wants to be right. By the second attempt at formal testing, it was clear he hated it -- he took one look at the little booklet, slid off his chair, and lay in a limp heap on the floor. When dragged upright, he slapped at the booklet, refusing to look at the test items.

At home, with formats based on the clinical tests, he is eager to match like items or pick out unlike, to match words and numbers, to read a sentence and find the picture that fits ... but only if told instantly that he's right or wrong, and allowed to learn why a wrong answer is wrong. It's as if he won't waste time on something that is not a learning experience for him. Perhaps a reasonable attitude in one who struggles to make the world understand what he wants to learn, that he can learn.

Which leaves us -- all of us who work with him -- with a dilemma. It seems obvious that an evaluation which doesn't find the "real child" can't form a basis for diagnosis or treatment. Whether the child "should" or "shouldn't" be that different during evaluation is beside the point; the real child is both children, but the one we want to encourage is the lively, competent, adventurous one at home. We can't do that if we don't know what his real abilities are. Eventually, we hope the child will show his best performance in a standard test setting -- but until he does, we have to nurture the real abilities as well as work on the real disabilities. It will do us no good to think he has problems in attention or pursuing a goal, when the real problem is which goal he chose to pursue.

That means professionals must learn to recognize when a child is tense, frightened or covertly uncooperative and ask parents if he is ever more relaxed and concentrated at home or in other situations. Some professionals do not recognize tension, assuming that the child is relaxed after a set period of time. Others assume the child is, despite obvious tension and stress, performing at his best, and ignore or deny parent or teacher reports of better performance elsewhere. Both assumptions can be wrong, and thus degrade the value of the test results. If the test situation is the only one in which the child can't or won't do something, the situation (not those skills or abilities) is the limiting factor. If it is representative of situations in which the child does less well, analyzing those situations may suggest ways to help the child learn to cope better.

In the meanwhile, the real child has learned, on his own, to do a lot of things the examiner was concerned about last time around. He's buttoning his own shirt, tying his own shoes, fixing his own waffles, assembling puzzles, and reading more advanced books which he takes to the library check-out desk himself. He is wild about geography; he loves to play any of a dozen games on the computer. He loads the dryer, puts away his clothes, runs errands, helps put groceries away, and follows safety rules. He can use "yes" and "no" correctly; he's beginning to use pronouns; he struggles to express more complicated ideas, confident now that l will listen and not interrupt until he gets it right. Occasionally (not often enough, but it's a beginrung) he addresses a phrase to someone not in the family; with a few regular visitors, he's become quite bold in asking for a sandwich or something to drink, or initiating a verbal game.

But the last time I asked if he would cooperate with the same examiner next time, he rolled up his eyes, stuck his fingers in his mouth, and looked past my ear, pretending blankness. Then he flashed me a very direct look, and a wicked grin, and said "No," cheerfully but firmly. Test Child will hide Real Child, for his own reasons which he cannot yet explain. Meantime, we nurture Real Child, protecting him from those who think Test Child's meager abilities are all he has to work with.

Elizabeth Moon lives in Texas with her husband, Richard, and son, Michael. She is a freelance writer of both fiction and non fiction. Moon has a B.A. in history from Rice University and a B.A. in biology from the University of Texas at Austin.
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Title Annotation:assessing disabilities in a child
Author:Moon, Elizabeth
Publication:The Exceptional Parent
Date:Jun 1, 1992
Previous Article:Changing practices.
Next Article:Educating parents.

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