New Haven Youth & Family Services
Youth Name: _______________________________________________
Date of Birth: __________________________________
Throughout each resident’s stay at New Haven, a multi-disciplinary treatment team evaluates and re-evaluates the Individual Service Plan designed for each individual based on the information we learn about the resident and family. One way to do this is through psychological and academic testing & assessments. New Haven incorporates several assessment processes to learn about the current functioning of each resident which includes cognitive abilities, academic learning, emotional functioning, thinking, and behavior. These assessments also help to identify and learn about each child’s problem thoughts and behaviors which enable us to plan positive strategies and teach new behaviors and coping skills.
Typically, the agency will use standardized tests & assessments, which, based on research, are known to produce reliable and valid findings. In some cases, non-standardized assessments may be used, if it is believed to produce useful information that would otherwise not be gained through a standardized test or assessment. Tests and assessments are issued either by a licensed psychologist or by an unlicensed professional with training that enables him or her to perform testing under supervision.
Both law and professional ethics require us to maintain complete confidentiality of all family information, communication, and assessment results. Because interpretation of the results requires clinical knowledge and training, only those who have an academic and experiential understanding of the reports will have access to the information contained within them. The agency can not release any information without your expressed written consent. Additionally, we will not release a copy of the final report or the content within, to anyone other than a trained and/or licensed professional.
You may obtain further information about these assessments and/or an explanation about the assessment results by speaking with your therapist. The following is a list of common assessments which may be used in the evaluation process:
- Casey Life Skills Assessment
- Functional Analysis of Behavior
- The Child & Adolescent Functional Assessment Scale (CAFAS)
- Kaufman Test of Educational Achievement (KTEA)
- Woodcock-Johnson III Tests of Achievement (WJ III)
I understand and consent to the psychological and academic testing and assessment as listed and described above.
Signature of Parent, Guardian, or Authorized Representative/ Date
Signature of NHYFS Representative or Witness/ Date