Diagnostic Assessments

Diagnostic assessments help to identify disorders which may otherwise be misunderstood as behavioral problems. This can be done through clinical observations, standardized testing, clinical rating scales, and corroboration from complementary sources of information. The proper identification of disorders directs us towards an evidence-based treatment plan and this helps to guide interventions greatly. The Open Nest provides standardized diagnostic assessments for children from as young as 2 years 6 months onwards to understand their psychological profiles and learning needs.

The reports provided by The Open Nest are written by registered psychologists and meet MOE/SEAB requirements. 

The Open Nest conducts a range of psychological assessments for:

Attention-Deficit Hyperactive Disorder (ADHD)

Suspecting or hearing that your child has ADHD (also known as ADD) can trigger a number of feelings. It can also raise many questions, including “what is ADHD?” You may wonder about symptoms, evaluations and how you can help.

The journey of parenting a child with ADHD can sometimes feel lonely. But you’re not alone. Learning as much as you can about ADHD is a great first step to getting your child the help he needs. 

What is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.

  • Inattention means a person wanders off task, lacks persistence, has difficulty sustaining focus, and is disorganized; and these problems are not due to defiance or lack of comprehension.
  • Hyperactivity means a person seems to move about constantly, including in situations in which it is not appropriate; or excessively fidgets, taps, or talks. In adults, it may be extreme restlessness or wearing others out with constant activity.
  • Impulsivity means a person makes hasty actions that occur in the moment without first thinking about them and that may have high potential for harm; or a desire for immediate rewards or inability to delay gratification. An impulsive person may be socially intrusive and excessively interrupt others or make important decisions without considering the long-term consequences.                                   

A good way to understand ADHD is to establish what it isn’t. It isn’t the result of bad parenting or of your child being lazy or disobedient. ADHD is a biological condition that makes it hard for many children to sit still and concentrate.

Children don’t outgrow ADHD. The symptoms may change over time but ADHD is a lifelong condition. That doesn’t mean your child cannot be happy and successful. There are many effective strategies and treatment options you can try to manage your child’s symptoms.

Kids (and families) are all different, so not all options will work for you. It usually takes several attempts to learn what fits your child and your family. But finding the right strategies and seeing an improvement can boost everyone’s confidence and bond the family together.

Types of ADHD
For many people, the words “hyperactive” or “out of control” come to mind when they hear the term ADHD. If your child doesn’t have those symptoms, a diagnosis of ADHD can be puzzling. Kids who don’t seem hyperactive often aren’t diagnosed as early.

There are actually three types of ADHD, and one of them doesn’t include symptoms of impulsive and hyperactive behavior.

  • ADHD, Predominantly Hyperactive-Impulsive Presentation: Kids who have this type of ADHD have symptoms of hyperactivity and feel the need to move constantly. They also struggle with impulse control.
  • ADHD, Predominantly Inattentive Presentation: Kids who have this type of ADHD have difficulty paying attention. They’re easily distracted but do not have issues with impulsivity or hyperactivity. This is sometimes referred to as attention-deficit disorder (or ADD).
  • ADHD, Combined Presentation: This is the most common type of ADHD. Kids who have it show all of the symptoms described above.

Learning Disorder Assessments

Signs of dyslexia can be difficult to recognize before your child enters school, but some early clues may indicate a problem. Once your child reaches school age, your child's teacher may be the first to notice a problem. Severity varies, but the condition often becomes apparent as a child starts learning to read.

Before school

Signs that a young child may be at risk of dyslexia include:

  • Late talking
  • Learning new words slowly
  • Problems forming words correctly, such as reversing sounds in words or confusing words that sound alike
  • Problems remembering or naming letters, numbers and colors
  • Difficulty learning nursery rhymes or playing rhyming games

School age

Once your child is in school, dyslexia signs and symptoms may become more apparent, including:

  • Reading well below the expected level for age
  • Problems processing and understanding what he or she hears
  • Difficulty finding the right word or forming answers to questions
  • Problems remembering the sequence of things
  • Difficulty seeing (and occasionally hearing) similarities and differences in letters and words
  • Inability to sound out the pronunciation of an unfamiliar word
  • Difficulty spelling
  • Spending an unusually long time completing tasks that involve reading or writing
  • Avoiding activities that involve reading

Teens and adults

Dyslexia signs in teens and adults are similar to those in children. Some common dyslexia signs and symptoms in teens and adults include:

  • Difficulty reading, including reading aloud
  • Slow and labor-intensive reading and writing
  • Problems spelling
  • Avoiding activities that involve reading
  • Mispronouncing names or words, or problems retrieving words
  • Trouble understanding jokes or expressions that have a meaning not easily understood from the specific words (idioms), such as "piece of cake" meaning "easy"
  • Spending an unusually long time completing tasks that involve reading or writing
  • Difficulty summarizing a story
  • Trouble learning a foreign language
  • Difficulty memorizing
  • Difficulty doing math problems

When to have a psychological assessment

Though most children are ready to learn reading by kindergarten or first grade, children with dyslexia often can't grasp the basics of reading by that time. Talk with your psychologist if your child's reading level is below what's expected for his or her age or if you notice other signs of dyslexia.

When dyslexia goes undiagnosed and untreated, childhood reading difficulties continue into adulthood.

Dyslexia tends to run in families. It appears to be linked to certain genes that affect how the brain processes reading and language, as well as risk factors in the environment.

  • Trouble learning. Because reading is a skill basic to most other school subjects, a child with dyslexia is at a disadvantage in most classes and may have trouble keeping up with peers.
  • Social problems. Left untreated, dyslexia may lead to low self-esteem, behavior problems, anxiety, aggression, and withdrawal from friends, parents and teachers.
  • Problems as adults. The inability to read and comprehend can prevent a child from reaching his or her potential as the child grows up. This can have long-term educational, social and economic consequences.

Children who have dyslexia are at increased risk of having attention-deficit/hyperactivity disorder (ADHD), and vice versa. ADHD can cause difficulty sustaining attention as well as hyperactivity and impulsive behavior, which can make dyslexia harder to treat.

Autism Spectrum Disorder Assessments

Autism Spectrum Disorder, also called ASD, is the name used for a specific set of behavioural and developmental problems and the challenges that go with them. A diagnosis of ASD means that your child’s communication, social, and play skills are affected in some way.

The word spectrum in ASD means that every child is unique and has his own combination of characteristics. These combine to give him a distinct social communication and behaviour profile.

As your child grows and develops, the nature or expression of these problems and challenges may change based on his biology and environmental experience. Usually a person with ASD will have some form of social and/or behavioural differences for the whole of her life.

A diagnosis of ASD is based on what a psychologist observes and learns about your child’s behaviour and development in the early years. That person needs to find out about your child’s history, particularly the early years, by talking to you and anyone else who knows him well.

The “gold-standard ASD assessment” is very detailed and it covers aspects of the child’s

  1. Level of Intellectual Functioning
  2. ASD characteristics and impairment
  3. Ability to take care of himself
A proper assessment will confirm suspicions of whether a child has ASD or not, and this will strongly guide the intervention process. Referrals to ASD friendly interventions, such as direct applied behavioural analysis, social skills trainings, community support, appropriate preschools/primary schools/special schools in Singapore for people with ASD, will make a very big impact in providing your child with the most optimal learning environment, learning pace and specialized teaching methods to help your child.

IQ Assessments

A typical intelligence quotient (IQ) test requires your child to solve some problems in a given time under supervision. In the IQ test, there are many subtests. Some require your child to respond to the questions verbally while others require your child to make patterns with coloured blocks and to look at some pictures. Some of these mini tests are timed, so your child will need to do as many questions in the mini test as he or she can within a time limit. The whole test takes about 1 to 2 hours to administer depending on the age of your child.


Traditional IQ tests focus on measuring linguistic (language) and logical (analytical) intelligence.

 IQ Assessments are helpful for children when:

  • Your child has difficulty coping with his or her current school demands.
  • There is a concern whether your child is ready for Primary 1 in a mainstream school.
  • Your child may benefit more from a special education service rather than mainstream education.
  • Your child has any existing medical condition or is on any medication that may affect his or her learning or thinking ability.


IQ is usually stable over time and unless there are unusual circumstances, re-testing of IQ within 2 years is not recommended. 

School Readiness Tests

School readiness tests are typically administered to understand if a child is ready for formal schooling (Grade One). A child is considered school ready when deemed to be able to cope with the formal demands (intellectual, emotional, conceptual, adaptive functioning) of schooling. Children are deemed to be intellectually school-ready if they score a mental age of 6 years 3 months on standardized school readiness assessments.

Why is it important to be school-ready

Besides the obvious implication that a child who is not school-ready will simply not cope in class and will more than likely fail the academic year, one has to keep the significance of the first school year in mind. A child who is not ready for grade 1 will most likely feel completely overwhelmed in class, and may develop a fear or dislike of school all together. The child might also notice that all his classmates are able to cope with tasks that he finds difficult and may begin to think that there is something wrong with him. This may lead to a low self-esteem.

It is thus crucial to establish that a child is indeed “school ready” before enrolling them for Grade One.

Special School Assessments

Intellectual disability is a developmental disorder where the individual faces more difficulty than others in grasping concepts and solving problems. The international definition for intellectual disability has three criteria:

  • Significant limitations in intelligence (classified as an IQ level of 70 or below)
  • Significant limitations in the skills needed to live and work in the community, including difficulties with communication, self-care, social skills, safety, and self-direction.
  • Limitations in intelligence and living skills are evident in the developmental period (i.e. before the person is aged 18 years) 


Referrals to special schools in Singapore for people with intellectual disabilities will be most helpful in providing your child with the most optimal learning environment, learning pace and specialized teaching methods to help your child. We note that in mainstream schools, the teacher-student ratio is large and teachers are often unable to spend extra time or use a different teaching method to help students with intellectual disabilities. Over time, this may result in low self-esteem for the child. This low self-esteem may manifest as anger outbursts, constant irritation and even school avoidance. 

Adaptive Functioning Assessment

MENSA/Giftedness Assessments

What does it mean to be a gifted child? There is no broadly accepted definition. Schools generally look at ability and intelligence tests, but do not all use the same standard. For example, one school might consider students at the top 10% gifted and another school might only consider the top 2.5%.

Although a precise definition cannot be agreed upon, there are characteristics that indicate testing be considered. Gifted children come from all backgrounds and socioeconomic statuses and exhibit different behavior than that of their peers. There are many characteristics and not all children will have all the characteristics. In addition, a child may have some of the characteristics and not be gifted.

Highly gifted children are generally identified easily because of highly unusual behavior, and achieving developmental milestones much earlier than their peers. Some of the behavior characteristics include having boundless energy, being an early and avid reader with advanced comprehension of language, talking early and exhibiting large vocabulary and being a problem solver who is not always satisfied with an answer. Additionally, gifted children might question everything, become easily bored with repetitive tasks and learn things quickly and at an advanced level, as well as exhibit perfectionist standards and become critical of themselves. This is why sometimes, gifted children may be thought of having ADHD.

Gifted children might also be more comfortable around adults than same age peers and be interested in adult problems, such as social issues at a young age, as well as work independently. Additionally, gifted children might have advanced humor, be persistent and have internal motivation and intense focus. in some cases, they might also be bullied by other children.

Do contact us if you have any queries about giftedness.


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