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S.P.A.R.C. |
| Separated Parenting Access & Resource Center
"Keeping Families Connected"
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Types of Evaluations
Psychological evaluations occur in any setting where it is necessary to
objectively evaluate human behavior. However, evaluations are often
categorized into the following domains:
Diagnostic Evaluations focus on assessing the normal and abnormal nature
of a person's overall functioning. The specific nature of these evaluations
vary depending on the issues to be addressed, but they involve at least the
following components: a clinical interview, a mental status examination, and
one or more psychological tests. These evaluations can be brief with the
psychological testing limited to one or two short questionnaire which focus
on specific concerns, or they can be long, comprehensive evaluations
consisting of lengthy objective and projective measures of personality.
Sometimes measures found in other evaluations may be included for more
breadth, such as intellectual assessment instruments or brief
neuropsychological screening measures.
Forensic Evaluations are often very limited in scope, with the specific
nature of the evaluation varying on the clinical and legal issues at hand.
As with diagnostic evaluations, these include a clinical interview, but may
or may not involve a mental status or psychological testing. When
psychological testing is included, psychologists often take measures to
evaluate the accuracy of the testing in order to account for possible
deception. Because of their limited scope, these evaluations are often short
and quick. However, custody evaluations can often prove to be the
exception. Family courts and/or private attorneys often require detailed
information regarding almost everyone involved in a custody dispute to come
to equitable arrangements. These evaluations may involve testing
step-parents and distant third-parties that may only be minimally involved
(e.g., a new companion of a parent or grandparents that have involvement
with the children, etc.). Thus, these evaluations can be lengthy and very
detailed, involving interviews, testing, and periods of family observation.
Neuropsychological Evaluations are often the most focused, but
lengthiest of evaluations. Designed to assess the neuropsychological
functioning of an individual, these evaluations consist of batteries of
tests that can require up to 8 hours to complete. Comprehensive in depth
and breadth, they focus on the process of neurological functioning and
should not be confused with neurological tests, often performed with MRI's
and/or CAT scans, which focus on structure. Neuropsychological evaluations
are performed by trained neuropsychologists are require extensive training
for appropriate administration and interpretation. The two most commonly
used batteries are the Halstead-Reitan Neuropsychological Battery and the
Luria-Nebraska Neuropsychological Battery. There are cases where a complete
battery is not necessary and brief screenings suffice; however, in such
cases the screening is part of a more comprehensive evaluation focusing on
another issue.
Educational Evaluations are often the most limited in scope, focusing
only on the intellectual functioning of individuals, with limited forays
into areas that may impact the educational requirements of the person.
These evaluations are generally performed in schools and are often done to
determine the services a child may need, the type of class in which he or
she should be placed, and/or to determine the type of guidance the child may
need in the future.
Vocational Evaluations focus on helping individuals make career choices
whether as adolescents and young adults trying to determine a possible
career path or adults considering a change. Such testing may occur in
college counseling centers or in employment settings.
Components of an Evaluation
Clinical Interviews are the primary method of gathering psychological
information and no assessment is complete without one. Interview vary from
completely unstructured approaches in which the clinician follows the story
told by the individual to structured interviews in which specific questions
are asked in a precise order. However, most interviews lie somewhere
in-between these extremes. The core of a clinical interview is history
gathering, focusing on the development of the person and on the development
of the presenting problems. The depth to which this history is explored
depends on the nature and context of the evaluation.
Mental Status Examination is often conducted as part of the clinical
interview or may not even be directly addressed if the clinician is able to
assess the mental status of a patient from observation alone. A mental
status is a means of assessing the person's current thought processes,
emotions, and interpersonal qualities. An individual's mental state can
impact the rest of an evaluation and provides a clinician with a gauge to
qualitatively assess and interpret data from other areas of an evaluation.
The mental status can also provide clues to areas that may need to be
addressed in follow-up sessions or outside referrals.
Objective Personality Tests are paper-and-pencil self-report inventories
that consist of true-and-false or multiple choice questions. They come in
a variety of forms, from lengthy measures of global functioning, such as the
Minnesota Multiphasic Personality Inventory (MMPI-2) and the Personality
Assessment Inventory (PAI) to short measures focusing on specific concerns,
such as the Beck Depression Inventory (BDI-II). Generally no more than one
global measure is included in a clinical battery and this measure often
forms the core of such a battery. Furthermore, global measures are
available in a number of different forms that can be used with different age
groups.
These measures often have strong psychometric properties and are interpreted
by comparing them to data gathered from a population sample that is
considered the norm. The degree to which this comparative population is
truly the norm has implications for accurate interpretation and this is one
of the reasons that measures such as these are continually revised. For
example the original MMPI was normed on a 1950's population that was no
longer reflective of the current United States census, resulting in a
re-Norman when the MMPI-2 was developed.
Projective Personality Tests are a diverse set of tools. The commonly
used approaches include inkblots (i.e., the Rorschach) in which the
individual must describe what is seen in a given inkblot, story-telling
tests such as the Thematic Apperception Test (TAT) in which stories are told
regarding a series of pictures, word association tests, and drawing tests
such as the Draw a Person or the Kinetic Family Drawing. These measures are
often used as supplements to objective tests, with the Rorschach one of the
most frequently administered measures.
These tests are controversial in their psychometric properties, and most
clinicians define them as clinical tools rather than tests. Interpretations
are often based on clinical judgement with only minimal objectivity. A
notable exception is the Rorschach, for which admirable attempts have been
made toward objectifying this test. However, projective measures are
commonly employed and, in the hands of a skilled clinician, found to yield
clinically relevant ideograph data that could not be assessed using other
methods.
Aptitude Tests are measures specifically designed to assess an
individual's cognitive and intellectual functioning. These tests can be
divided in two sub-categories: intelligence tests and achievement tests.
The former measure a person's intellectual functioning in terms of their
ability to to learn and provide information in the form of an IQ, while the
latter measure what a person has learned and provide information in terms of
grade equivalents. As with other psychological measures, these tests can be
lengthy and comprehensive or short screening measures. Commonly used
intelligence tests include the Wechsler Adult Intelligence Scale - III
(WAIS-III) and the Wechsler Intelligence Scale for Children - III
(WISC-III), while major aptitude tests include the Wechsler Individual
Achievement Test (WIAT) and the Wide Range Achievement Test (WRAT).
The historical antecedents of modern day testing, these tests are
considered the hallmarks of psychometric strength. Yet, controversies
abound regarding their use: How does one define intelligence? Is IQ an
accurate measure? Are intelligence tests fair to minorities?
Specialty Measures include any number of tests designed to address
specific questions. These types of tests may compose a battery unto
themselves (e.g. the special neuropsychological tests that make the
Halstead-Reitan) or may be specialized instruments that supplement other
measures (e.g. measures designed to assess for deception in forensic
evaluations or tests designed to answer a specific legal question)
Psychometrics
Psychological Assessment is a science based on objectively measuring
characteristics of human behavior. In order to do so, psychological
measures must meet certain criteria to be considered objective measures. A
complete discussion of psychometric theory is beyond the scope of this brief
exploration, but the following characteristics are important to consider:
Norms are used as a reference against which psychological test data is
interpreted. They consist of the test performance of a standardization
sample that is reflective of the general population under consideration.
Without normative data, the information obtain regarding a person is
meaningless. Norm provide a means of assessing a person's relative standing
in comparison to others. There are various types of norms that serve
specific purposes, with the two most common types presented here:
- Development norms are used to assess how far along the normal development
path a person has progressed. They include comparing IQ, grade equivalence.
- Within-Group norms are used to evaluate a person's performance in terms of a
similar comparison group. For example, comparing a child's performance to
others his or her age, or comparing a schizophrenic patient to other
schizophrenics.
Reliability refers to the consistency of scores obtained by a person
when re-examined. The degree to which a test is reliable defines the
accuracy with which it assesses the person. A test which is reliable does
not necessarily measure what it is supposed (this is validity to be
addressed next). For example, a person who consistently throws darts on the
border of a dartboard is reliable in her performance, however she is not
valid in the sense that she is not doing what is supposed to be done
(hitting in the scoring region of the board). There are different methods
for assessing reliability, each of which is useful under different
circumstances:
Test-Retest Reliability is determined through the administration of an
identical test over different occasions and shows the extent to which scores
on a test can be generalized over different administrations. Although
generally useful, this type of reliability has limitations. Some behaviors
fluctuate extensively and it is necessary to take this into consideration
when using test-retest reliability. More seriously, are issues related to
the impact practice may have on a test. This type of reliability is useful
for measures of stable personality traits, but not for measures of aptitude,
where practice severely impacts performance on future administrations.
Alternate Form Reliability combines test-retest reliability with the
administration of two different versions of a test. In using this method of
reliability analysis, it is imperative that the tests truly be parallel
versions.
Split-Half Reliability uses statistical procedures to determine
reliability from the single administration of one form of a test. This is
the most commonly used approach for determining reliability with aptitude
tests and the most effective. It is also appropriate in cases where the
trait assessed is likely to fluctuate extensively.
Validity addresses what a test actually measures and how well it does
that, and tells the examiner what can be interpreted from test scores.
Tests are validated in regards to a particular use - one cannot say that a
particular test has "high" or "low validity" in general terms (however, in
common parlance it is common to refer to an established test as having high
validity because it is commonly understood what the test measures).
Basically, the validity of any test is determined by comparing it to another
test or some observable fact (i.e., validity is always based on external
relationships). The types of validity are as follows:
Content Validity refers to the systematic determination of whether the
content of a test measures the traits that it is designed to measure. This
type of validity is built into the test when it is constructed through the
selection of appropriate items. Related to content validity is face
validity, which measures the degree to which a test superficially appears to
measure the trait at hand. Although it is considered desirable for a test
to have face validity, this may not always be the case. For example, on
measures geared toward the assessment of malingering and deception, low face
validity may aid in more effective detection.
Criterion Validity refers to the degree to which a test predicts the
person's performance on future, specified activities. In such cases, the
performance on the test is compared with performance on the predicted task.
Construct Validity refers to the degree to which the test measures the
underlying theoretical construct. Such validation is often the core of
theoretically derived tests such as the MCMI-III and the PAI in personality
assessment, or the Woodcock-Johnson Revised Educational Battery in aptitude
assessment.
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