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Part 3 of 3: Assessing Oppositional Defiant Disorder

Part 3 of 3: Assessing Oppositional Defiant Disorder

(This three-part article is by Dr. James Sutton. It is from his newest book, “What Parents Need to Know About ODD.” This book is available to be downloaded in e-book format from


Projective assessment: Projective assessment consists of questions and challenges that have no right or wrong answers. This assessment serves to evaluate how youngsters structure their responses to the tasks. Assessment instruments include the famous “ink blot” cards, sentence completion questions and open-ended thematic (story) cards. The examiner looks for content and patterns of responses that can lend insight into the child’s emotional and psychological state. Since youngsters typically have little experience with projective assessment, this part of the evaluation is difficult for the child to “fake” or manipulate. For the same reason, it’s a part of the assessment that can make them uncomfortable. But even this discomfort is diagnostically valuable; it shows how youngsters handle situations they cannot control.

Diagnostic Interview: I put the diagnostic (clinical) interview at the end of the assessment because it can affect rapport. However, in the hands of a skilled and compassionate interviewer, it can deepen rapport. It just depends. I use an interview I wrote; it consists of 155 questions that sample a child’s perception of how they operate in the essential “Life Fields” of school, home and community, peers and self. The interview is extremely comprehensive, covering everything from relationships to drug/alcohol use to depression to suicidal thoughts or gestures. (Obviously, I don’t use the whole interview with young children.) The interview not only collects valuable information in the child’s own words, it lets the child consider their needs and priorities for intervention. What better place to start counseling or therapy than with an issue the child already sees as pertinent?

A Written Report:  Any psychologist will tell you that the most difficult part of an assessment is the challenge of making sense of all the information collected. This involves pulling together all the pieces and parts into a narrative interpretation of the assessment, providing a diagnosis (if appropriate), and offering plenty of practical recommendations for treatment and intervention at home and school.

Who Can Do An Assessment? 

A comprehensive assessment is usually done by a psychologist, but it can be done by anyone having the training and certification or licensure to do so. I recommend that parents find someone who specializes in children and adolescents. A referral from a pediatrician would be a good place to start, as would the psychology or special education departments of a local university. Large counties, especially those with large cities, often have a psychological association; members can be accessed through a referral line. Also, child psychiatrists sometimes have a psychologist on staff or available to do assessments.

Fees vary, but generally run between $500 and $1500, depending on customary fees in the area and, quite frankly, the reputation and track record of the assessment professional. These expenses are usually covered, at least in part, under health insurance.

(Go to the “FREE ARTICLES” or “THE ODD PAGE”  link from to read additional information about Oppositional Defiant Disorder.)


July 27, 2006 - Posted by | Difficult Child, Educators, Parents

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