When Your Child's Grades Don’t Tell the Whole Story: How Testing and Assessment Can Help

Psychological Testing & Assessment for Children and Adolescents in Austin

For many parents, a child’s success in school is crucial to setting up their success in life. Some children thrive in the schooling environment, but other children may have challenges. Some of these challenges may be clear, but for others, the picture may be more complicated. In the school system, grades and test scores are the main methods for determining a child’s progress. While this data is valuable, it often hides underlying causes of difficulty. Some children earn high grades, but they report dissatisfaction with their performance in school or feeling as if they are struggling. Other children earn grades that do not reflect their potential. In both cases, these children may require mental health or learning interventions as well as possibly accommodations in the school system. The assessment process can help determine some of the challenges these children are experiencing and identify methods for reducing the impact of those challenges. All assessments will include specific recommendations for helping address the presenting concern that led to the assessment. Below are specific areas that can affect a child’s performance in school and the ways in which the assessment process can identify their impact on the child.

Identifying Anxiety and Depression Through Psychological Assessment

There are several types of anxiety disorders. Some involve anxiety focused on specific fears (e.g., specific phobias, social worries, and worries about separating from an attachment figure). Some involve anxiety without a clear trigger, like in panic disorder, which involves panic attacks that occur out of the blue. Others, like generalized anxiety, involve worry about many different domains for much of the time. All anxiety disorders, however, can affect performance in school and the ability to learn. For example, when a child is focused on their worries when they are supposed to be focused on their teacher’s lesson or on schoolwork, they will see an effect on their learning and performance. Some types of worries can have specific effects on school performance. For example, if a child has a phobia about storms, they may have trouble attending school on days that are not sunny or lose focus in class when it begins to rain. Social anxiety can also have broad effects on learning, as it can lead to challenges making presentations, writing on the board, eating in the lunchroom, using the bathrooms at school, completing group projects, and on many other activities in the school day. Children with separation anxiety may struggle with school refusal.

Depressive symptoms can also affect functioning in school. These symptoms must include at least one of the following symptoms for most of the day on most days for at least 2 weeks: down mood, irritable mood, or lack of interest or pleasure in most activities. Additional symptoms may include changes in weight or appetite; difficulty with sleep, including either insomnia (difficulty falling or staying asleep) or hypersomnia (excessive sleep); feeling restless or slowed down; fatigue or loss of energy; feelings of worthlessness or excessive guilt; difficulty thinking, concentrating, or making decisions; and recurrent thoughts of death or suicidal thoughts. Children experiencing depressive episodes may struggle with the motivation to complete schoolwork or even attend school, which can lead to tardiness or missing school entirely. Some depressive symptoms, such as fatigue or difficulty concentrating, can lead to difficulty completing many tasks that are expected of children in school and at home. Of note, depressive symptoms do not have to include a sad mood, which highlights the importance of careful diagnosis.

Through the testing process, anxiety and depressive symptoms can be assessed with rating scales completed by parents, teachers, and, if they are old enough, the child. Other data is collected through observations during the testing process and diagnostic interviews conducted with parents and/or the child.

Obsessive-Compulsive Disorder (OCD) Assessment in Austin, Texas

OCD is a disorder characterized by obsessions and compulsions, both of which can interfere in the school environment. Obsessions are intrusive thoughts that occur repeatedly and cause distress, impairment, and/or are time consuming. Compulsions are repeated behaviors that are typically done in order to gain relief from the distress caused by those thoughts. While most compulsions are behaviors that others can observe, some occur only mentally and are easier to miss. For some people, all of their compulsions are mental, making it more difficult for them to receive the correct diagnosis. Mental compulsions are also easier to do than other compulsive behaviors, and children sometimes do not even realize that they are doing a mental compulsion in the moment. Because mental compulsions can be done quickly and surreptitiously, they can be particularly disruptive in the school environment, as they will take children away from the tasks at hand.

Like anxious and depressive thoughts, intrusive thoughts of any kind can also be distracting during lessons and schoolwork. Some types of OCD will also lead to impairment in many of the activities in which children are expected to engage in school. For example, someone with intrusive thoughts about harming others may not be able to participate in, such as someone with contamination fears not being able to participate in dissection in biology. Other types of OCD may lead to tasks taking longer than they should, such as children who experience re-writing compulsions that can extend the length of any assignment that involves writing, including note taking. Additionally, there are many presentations of OCD that are different than the common presentations in media and popular discourse; those presentations are typically limited to compulsions such as hand washing and just-right compulsions like making objects even (i.e., trying to make something “just right”). Presentations of OCD are as varied as human personalities, so less commonly known presentations must be evaluated thoroughly for someone to receive the proper diagnosis. Assessment is one way of identifying OCD. Rating scales completed by the family and the child (when old enough) can be a starting point, and specialized interview measures for OCD can be administered to a caretaker and/or the child when possible. Cognitive testing can be helpful for identifying any cognitive challenges that may be caused by or exacerbating anxiety or depression. Observations can also provide valuable data for identifying OCD, and cognitive testing can be an opportunity for collecting observations.

ADHD Testing for Children and Teens in Austin, Texas

One of the most common reasons that parents seek assessment is to determine whether their children are experiencing ADHD. The three primary types of ADHD are a predominantly inattentive presentation (ADHD-PI), a predominantly hyperactive/impulsive presentation (ADHD-PHI), and a combined presentation (both inattentive and hyperactive/impulsive symptoms, or ADHD-C). Inattentive symptoms include careless mistakes, difficulty sustaining attention, difficulty with organization, becoming easily distracted, forgetful, etc. Hyperactive and impulsive symptoms include fidgeting, acting as if “driven by a motor,” excessive talking, interrupting, difficulty waiting their turn, etc. Inattentive symptoms can interfere with aspects of school such as completing schoolwork, focusing during lessons, remembering assignments. Hyperactive and impulsive symptoms can interfere with aspects of school such as the relationship between teachers and the child, sitting through lessons, and working quietly. Children with ADHD often feel as if they are being frequently corrected, which can affect self-esteem. Rating scales, observations during testing, and, if needed, diagnostic interviews are helpful for diagnosing ADHD. ADHD requires that symptoms be present in more than one setting, so it is crucial to obtain reports of symptoms from more than one environment. Most often, rating scales will be completed based on the home environment (e.g., parent report) and the school environment (e.g., teacher report). Additionally, other causes of the ADHD symptoms must be assessed. More on that in the differential diagnosis section below.

Trauma and PTSD Assessment for Children and Teens in Austin, Texas

When children have traumatic experiences, it can cause symptoms consistent with post-traumatic stress disorder (PTSD). Regardless of whether children meet full criteria for PTSD, even the presence of some symptoms can affect children’s school functioning. These symptoms may include the following, among others: intrusive memories of the traumatic event; dissociative reactions, such as flashbacks, that feel as if the person is reliving the traumatic event; avoidance of stimuli associated with the traumatic event; inability to remember important aspects of the traumatic event; persistent and exaggerated negative beliefs about the self, others, or the world; substantially reduced interest or participation in significant activities; inability to experience pleasant emotions; etc. Trauma symptoms can lead to difficulty concentrating in lessons and when completed schoolwork. Some children may also experience behavioral challenges due to trauma symptoms, which can lead to children getting in trouble at school and having difficulty getting along with teachers and peers. They may also struggle with motivation for school in general. Rating scales and diagnostic interviews are crucial for assessing the impact of these symptoms and whether they fit diagnosis of a trauma-related disorder. Cognitive testing can also assess any areas of difficulty that may be caused by the trauma symptoms or even just may be contributing to challenges.

Academic and Cognitive Testing for Learning Differences in Austin, Texas

Learning disorders in math reading, and writing (also sometimes referred to as dyscalculia, dyslexia, and dysgraphia) are sometimes the reason for academic challenges, especially when they are occurring in specific classes. Learning disorders can be diagnosed based on any type of difficulty in that domain. For example, someone with a learning disorder in reading may struggle with decoding words or understanding the content of what they are reading, but they do not need to have difficulty in all areas of reading to qualify for that diagnosis. Children with learning disorders will struggle in the area of impairment when compared to their peers, and they will require interventions to reach their grade level in that area. Learning disorders are assessed through ability and academic testing. Ability testing identifies cognitive skills that may be challenges or strengths and rules out intellectual disabilities. Academic testing assesses progress in reading, writing, and mathematics, including specific assessment of different types of skills each area. Specific skills in which children are struggling can be paired with related academic interventions that are tailored to their needs.

Why Accurate Diagnosis Matters for Treatment and School Support

One of the most helpful aspects of assessment is differential diagnosis, in which the child is considered as a whole, and possible diagnoses are considered jointly. This is important because many diagnoses have overlapping symptoms. For example, OCD, inattentive ADHD, depression, and anxiety can all involve distraction or difficulty concentrating. The assessment process helps identify which diagnosis or diagnoses best explain the symptoms. Additionally, if the symptoms are only occurring in one setting, this means that a diagnosis other than ADHD must be present, and the assessment process allows an opportunity to collect the needed data to make this determination. Learning disorders can be the cause of some what is sometimes misidentified as ADHD, especially if the symptoms only occur in one subject, so testing to rule out learning disorders is needed in ADHD evaluations. This also provides helpful data for behavioral observations and can identify ways in which ADHD may be affecting cognitive functioning.

Meet Our Assessment Psychologist: Dr. Rebecca Suffness

Dr. Rebecca Suffness

Licensed Psychologist and Assessment Specialist serving children, teens, and adults in Austin, Texas

Dr. Rebecca Suffness is a licensed psychologist specializing in comprehensive psychological assessments for children, adolescents, and young adults. She has extensive experience evaluating anxiety disorders, OCD, ADHD, learning differences, and related concerns, using structured interviews, standardized assessments, and careful observation to provide clear and accurate guidance.

Dr. Suffness earned her Bachelor’s degree in Psychology from Duke University and her Master’s and PhD in Clinical Psychology from the University of North Carolina at Greensboro. She completed an APA-accredited predoctoral internship, gaining hands-on experience with school-based assessments and interventions.

Dr. Suffness values collaboration and works closely with families, clients, and referring treatment providers to understand each child’s unique needs, answer diagnostic questions, and provide actionable recommendations that support success at home, at school, and beyond.

Next Steps: Scheduling a Psychological Assessment in Austin

If you have concerns about your child’s learning, attention, emotional well-being, or school performance, a comprehensive psychological assessment can provide clarity and direction. At Austin Anxiety and OCD Specialists, our evaluations are designed to identify underlying factors, provide accurate diagnosis, and offer practical, individualized recommendations to support your child at home, at school, and in treatment. To learn more about our testing and assessment services or to schedule an evaluation, we invite you to contact our office.

Additional Mental Health Services for Children, Teens, and Young Adults

We understand that every child experiences anxiety, OCD, ADHD, and related concerns in their own unique way. Specific challenges, daily routines, and personal experiences shape the type of support that will be most effective. That’s why our care goes beyond assessment, offering flexible, evidence-based treatment options tailored to your child’s needs.

Our psychologists and therapists specialize in a wide range of concerns, including anxiety disorders, OCD, social anxiety, phobias, PTSD, depression, selective mutism, separation anxiety, tics, and body-focused repetitive behaviors. In addition to individual therapy and assessment services, we offer parent coaching, SPACE treatment for families, and group therapy.

For families across Texas, our secure online therapy platform delivers the same high-quality, research-backed care from home. We also offer Camp Courage, a hands-on therapeutic program where children and teens gradually face fears, build confidence, and strengthen coping skills in a supportive, developmentally appropriate environment.

Whether you are exploring therapy for the first time, seeking a structured assessment, or continuing ongoing care, our team provides compassionate, judgment-free support to help your child and family move toward greater resilience, steadiness, and long-term emotional well-being.