Dr. Steve Tutty Discusses the Science Behind Child Psychological Evaluations and Helping Children Reach Their Potential

A Career Shaped by Clinical Science

Steve Tutty is a licensed clinical psychologist with more than 25 years of direct practice in both Washington State and Utah. He specializes in child psychology, neuropsychology, and complex developmental concerns, helping children and adolescents, as well as their parents and academic team, understand their child’s/student’s unique learning strengths and challenges,, behaviors that allow the strengths to surface, strategies for managing BIG emotion at home and in the classroom, and making and keeping friendships.

For more than two decades, Tutty has taught, researched, and published in clinical psychology. His research includes published clinical trials involving ADHD and depression.

That background shapes how he approaches a neuropsychological evaluation. It is not a label applied after a brief meeting. It is a process for gathering information, identifying strengths, and translating findings into practical support. The process involves a multi-step process –  intake, testing phase, analysis of data, collateral input/interviews, feedback, and report draft before the final is released. For many clients, different report versions need to be crafted depending on the type of information released to specific audiences, and evidenced based accommodations that can be feasibly implemented.

Dr. Tutty has evaluated and treated more than 2,300 children and adolescents with complex developmental, behavioral, and learning needs. Many have presented with ADHD, autism , complex mood, and twice exceptional profiles -, in which advanced cognitive abilities (e.g., superior IQ) exist alongside significant challenges (e.g., dyslexia). His work is grounded in evidence based psychology and individual clinical understanding.

The discussion below explores how careful assessment can give families, schools, and children a clearer path forward.

Seeing the Child Beyond the Referral Question

What does a child psychologist look for during a psychological or neuropsychological evaluation?

A referral question typically begins with a concern over specific developmental issues. For instance, a parent may notice in their child a difficulty with focus or emotional regulation (e.g., managing BIG emotions). Other parents may notice challenges in their child making and keeping friends, getting bullied, or sensory sensitivities that other peers do not experience. Finally, there may be concerns with reading, writing, and mathematics, or always waiting until the final hour to complete schoolwork. A teacher may also see inconsistency compared to other age-related students. Those concerns matter, but they are a starting point rather than a final explanation.

A thorough psychological or neuropsychological evaluation considers the child’s developmental markers (from prenatal development to their current status), medical history, academic performance, family observations, behavior that both helps and hinder the learning process, and social/emotional experiences. Interviews, standardized testing measures across a broad range of domains – cognitive, academic, memory, attention, personality, and so on, as well as in-office observation add new layers of information to better understand the child as a whole.

Tutty emphasizes that no single test score should define a child. Results are most useful when interpreted alongside the child’s lived experience. A child who performs well on one task may not guarantee success in the classroom, while another child may show uneven skills that reveal both a high level of ability and a need for targeted support.

The goal is a fuller, more comprehensive picture of what is working, what is not working, and how to bridge the gap.. That process can help adults move beyond broad assumptions and toward tailored supports that translate insight into action.

Knowing When an Assessment May Help

When should families consider a psychological or neuropsychological evaluation?

Families often seek help when a concern persists and tends to affect daily life. Tutty notes that an assessment may be useful when a child repeatedly struggles at school, avoids manageable tasks, has difficulty sustaining friendships, or has emotional reactions (e.g., anger, sadness) or behaviors (e.g., social avoidance) that seem out of proportion to their age-related peers.

The decision does not require a crisis. Some families want a better explanation for patterns they have observed. They may be trying to understand why their child is bright but underperforming, why home and academic expectations create distress, or how their child can keep it together at school yet let it all out at home, like a tornado. 

An evaluation can also help when previous support has not produced clear progress and tailored interventions needed to help the child realize their potential.. A child psychologist can help examine how learning differences, attentional challenges, developmental conditions, and/or emotional experiences may be helping or hindering their child’s capacity to use their strengths.

For Tutty, timing matters just as much as clarity. A well planned psychological or neuropsychological evaluation can organize what is happening and guide what should come next for families.

Looking Carefully at ADHD Pathways

How does an ADHD assessment move beyond common assumptions about attention?

Society tends to view ADHD as a condition whereby the child or adult can’t sit still, as if driven by a motor with an endless power supply. However, there are many variants of ADHD that are important to understand.  Tutty’s clinical and research experience supports a broader view. Attention can affect organization, task initiation, working memory, visual and auditory memory, the capacity for seamless or disjointed multitasking,  impulse control, and emotional regulation.

A careful ADHD assessment considers whether those patterns occur consistently across settings (e.g., home, school, athletics, etc.) and whether they interfere with school, home life, relationships, and/or self confidence. It also considers other factors, such as sleep problems, diet and exercise, mood management, sensory concerns, and  family dynamics. 

A structured evaluation helps distinguish between a response to stress and a persistent pattern that may require support. It also helps families understand that ADHD can present differently from child to child. A child may struggle more with the inattentive type whereby they may be more internally distracted,  while other children may have more challenges with impulsivity and hyperactivity whereby they may be more externally distracted. 

Tutty’s approach identifies the specific type of ADHD and creative/tailored interventions for those conditions A child may be creative, socially engaging, or highly curious while still needing strategies for planning, follow through, and big emotion regulation.

Understanding Autism With Care and Context

What should families understand about an autism evaluation?

An autism evaluation should not be reduced to a checklist. Similar to an ADHD assessment, Tutty approaches autism as a developmental presentation that can affect communication, social understanding, flexibility, sensory processing, specific interests, and daily routines in different ways.

Many children show clear and early signs of autism, while other children (e.g., girls) can develop coping strategies that make the signs less visible (masking), especially in structured settings. For instance, a child may work hard to fit in at school (e.g., predicting and imitating social routines), whereby social and emotional challenges are less apparent, yet quite visible in other settings (e.g., home). . An effective evaluation considers those differences rather than assuming one setting tells the story.

For families, the process can bring both questions and relief. A clearer understanding may explain patterns that have been difficult to name. It can also help identify much-needed supports that improve communication, reduce unnecessary stress, and build on the child’s natural interest/strengths.

Tutty stresses that an autism evaluation should respect individuality to better understand how the child experiences their world from their eyes, and what tailored interventions can improve their capacity for reciprocal communication, even small talk, understanding emotions and facial expressions in others, using gestures when communicating, how to maintain eye contact even when it’s uncomfortable, creatively managing sensory experiences, and coping with unexpected changes to specific routines. 

The evaluation not only involves an assessment of their cognitive and adaptive functioning, but how they communicate, process and respond to emotions, connect with others, and essentially read the room. Tutty says the ADOS-II, among other tools, is useful in assessing individuals on the spectrum, and he routinely uses this assessment tool in youth and young adults regarding autism spectrum assessments.

Recognizing Twice Exceptional Learners

Why can twice exceptional children be missed in school and clinical settings?

Twice exceptional children may have outstanding intellectual, creative, or academic abilities while also struggling with executive functioning (e.g., ADHD), mood ( anxiety/depression), reading and writing (e.g., dyslexia), and so on. . Such strengths can mask areas of need, as such students can often ace the in-class test despite not completing any homework – which provide the building blocks for higher level learning needed later in their academic careers. 

Tutty has worked with children whose highly advanced vocabulary, perceptual reasoning, and knowledge about the world squashes their motivation for organization, task completion, and autonomous steps for independent living.

This uneven profile can confuse families and educators. A child may excel in one class and resist another. They may achieve high scores but need more effort to complete routine and repetitive work. Often with gifted learners, they have already solved the problem in their minds and therefore showing their work does not make sense. Without careful assessment, adults may call the child unmotivated or even defiant.

In particular, neuropsychological testing can help identify patterns across thinking, learning, attention, memory, and executive functioning that can be used to maximize their success by crafting the right interventions, such as advanced placement, project-based learning, and real-work applications of theory into practice (e.g., robotics), 

Turning Results Into Useful Support

What happens after psychological evaluation and neuropsychological testing are complete?

Assessment matters when families and schools feel stuck on how to unlock the potential of their child/student.. Tutty believes a report should not end with technical language or scores. It should explain findings in everyday terms and identify next steps that are practical and effective for educators and parents to implement. .

Recommendations may include school accommodations, tutoring,  therapy, parent guidance, skill building strategies, and medical referrals, among others. . For some children, the next step may be a change in how adults communicate expectations. For others, it may involve adjustments to their workload, testing conditions, or routines.

The strongest recommendations are specific and measurable, and seek to provide the child the means to access their true gifts and potential. They connect the child’s profile to real situations at home, school, and in social environments. A child who has difficulty with working memory, for example, may benefit from directions presented in a mulit-sensory process, with  smaller and digestible steps, and a system for monitoring and executing.   . A child who becomes overwhelmed by transitions may need advance notice with how to prepare for specific activities and routines. 

Tutty’s work reflects a practical standard for evidence based psychology. Assessment should produce information that helps people make better decisions, not simply more information to manage.

The Role of Research in Clinical Care

How does a scientific background influence the way a child psychologist works with families?

Tutty’s research experience reinforces the importance of asking careful questions and relying on evidence rather than assumptions. Clinical research requires clear methods, attention to outcomes, and a willingness to revise conclusions. Those habits also matter in individual care.

Families bring valuable knowledge about their child, while teachers and other professionals offer another view. A scientific practitioner looks for patterns supported by several forms of information.

This approach can be especially important when a child has overlapping concerns. Attention problems may exist with a learning difference. Anxiety may affect social behavior. Advanced abilities may exist alongside executive functioning challenges. The task is not to force every concern into one simple answer. It is to develop the most accurate explanation possible from available evidence and then figure out how to help unlock the unique cognitive, emotional, and behavioral strengths of each child.Tutty’s work with ADHD research and clinical practice reflects that commitment. He treats assessment as a process of careful, disciplined reasoning, not a shortcut to certainty.

Helping Children Move Forward With Understanding

What does it mean to help a child reach their potential?

Potential is not a score or a narrow definition of achievement. It is the opportunity to understand strengths, receive support for meaningful challenges, and participate more successfully in school, home, and social life.

A strong psychological or neuropsychological evaluation can help create that opportunity. It gives families language for experiences that may have felt confusing. It gives educators a clearer basis for support. It can also help children understand that difficulty in one area does not erase a strength in another.

This work requires care and respect for individual differences. Accurate assessment cannot solve every problem immediately, but it can reduce uncertainty and guide the next steps for meaningful change.

Steve Tutty’s career reflects a long term commitment to thoughtful practice. Through child psychology, neuropsychological testing, and evidence based care, he continues to focus on one essential question: what does this child need in order to unlock their potential??