CNS 540 Flashcards
Ethics
Moral principles adopted by an individual or group that prove the basis or right conduct
Rules/Regulations
Laws created by government agencies (Federal)
Law/Statue
Written by legislative bodies (Congress)
Qualification Level A
No special qualifications to purchase products
Qualification Level B
Certification by or full membership in a professional organization that requires training and expertise in a relevant area of assessment
OR
Masters level in related field and formal training in ethical administration, scoring, and interpretation of clinical assessments
Qualification Level C
High level expertise in test interpretation
Licensure/certification to practice in your state
OR
PhD in related field with formal training in ethical administration scoring and interpretation of clinical assessment
ACA Guidelines for test use qualifications
- Skill in practice/knowledge of the theory relevant to the testing context/type of CNS specialty
- Thorough understanding of testing theory, techniques of test constructions and test-retest reliability and validity
- Working knowledge of sampling techniques, norms, and descriptive correlational and predictive statistics
- Ability to review, select, administer tests appropriate for clients or students and the context of counseling practices
- Skill in administration of tests and interpretation of scores
- knowledge of impact of diversity on testing accuracy, including age, gender, ethnicity, race, disability, and linguistic
- knowledge/skill in the professionally responsible use of assessment/evaluation practice
ACA Code of Ethics - Section E
- The crucial importance of assessments being reliable and valid
- CNS responsibilities NOT to misuse assessment information, to share results with clients, interpretation of results, the use of information
- Informed consent
- Release of data and qualified professionals
- Diagnosis of mental disorders
- Instrument selection
- Scoring/interpretation
- Assessment security
- Multicultural/Diversity issues
- Obsolete assessments/outdated results
- Assessment construction
Ethical/Legal Issues in assessment
- Professional training/competence: knowledge, understanding to select, score, administer, interpret
- Responsibilities of test takers: high standards, knowledgeable, ask questions, listen/read carefully to what needs to be done, know location/schedule of test, follow instructions, report conditions that could have affected performance, know confidentiality
- Test Quality
- Client Welfare Issues: informed consent, confidentiality
- Internet testing: equivalence, appropriate norms, validity, security
- Multicultural differences: Language barriers, validity, reliability, etc
- Responsibility of test use
- Test user qualifications
- Judicial Decisions
- Statues/Regulations
Communicating the Results to the Public
- Discuss assessment Before/After testing
- Use common language: Strengths/Weaknesses
- Results presented simply while accurate/honest
- Percentiles/Stanines should be presented visually
- Statistical/measurement terms defined in simple language with examples
- The public isn’t stupid - don’t treat them as so
Communication with Colleagues
- know what information recipient needs, what they plan to do with it, and what their qualifications are
- Make sure ethical/legal precedes are followed (written release permission from client)
- Verify whether procedures established for test information
- Aim report directly at question asked
Purpose of written reports
- Describe client
- Describe problem
- record results for further use
- means of communication
- recommend appropriate course of action
Purpose of Clinical Assessment
- Diagnosis/screening
- Problem descriptions/case conceptualization
- Selection of treatment procedures
- Evaluation of treatment outcomes/progress
Basic Assessment Report Format
- Title and identifying information
- Reason for referral
- Background information
- Behavioral observations
- Assessment instrument/procedures
- Assessment results/interpretation
- Summary
- Recommendations
Methods of Reporting Test Results
- Group Sessions
- Individual Sessions
- Written Reports
- Computer-generated reports
- Video Approaches
- Oral Reports
Qualities of Well Written Reports
- Avoid jargon/abbreviations
- Refer to self in third person
- Use simple/concise words
- Avoid Redundancies
- Begin paragraphs with strong declarative sentences with supportive details
- Capitalize test titles
Four Phase Model of Feedback Sessions
Phase 1: Establish Rapport
Phase 2: Communication assessment results
Phase 3: Discuss recommendations
Phase 4: Terminate Interview
Common Language
T-Score: Mean = 50; SD = 10
Z-Score: Mean = 0; SD = 1
Stenin Score: Mean = 5; SD = 2
Sten Score: Mean = 5.5; SD = 2
SAT: Mean = 500; SD = 100
GRE: Mean = 150; SD = 10
Deviation IQ: Mean = 100; SD = 15
Developmental Domains
Communication: verbal/nonverbal, receptive/expressive, listening/comprehension
Cognitive Skills: reasoning, thinking, memory, basic achievement in reading, writing, math, problem solving
Physical Development: general growth, motor/sensory, balance, locomotion, walking
Emotional Development: temperament, adjustment, emotional expression, self-concept, attitudes
Social Development: peer/family relationships, interpersonal
Self-Care Skills: drinking, eating, toiling, dressing
Independent Living Skills: functioning individual in home and community, clothing, cooking, transportation, and money management
Work Habits/Adjustment Skills: working independently, maintaining proper work habits, working with employers
Adjustment Problems: agression, hyperactivity, acting out, withdrawal, delinquency, stress, depression
Commonly used assessments for ADHD
Broad
- Childhood Behavior Checklist (CBCL/6-18)
- Behavioral Assessment System for Children (BASC-2)
- Connor’s Rating Scales (CRS-R)
Specific
- ADHD System Rating Scale (ADHD-SRS)
- ADD Evaluation Scale (ADDES-2)
- ADH Rating Scale (AD/HD-RS-IV)
- Barkley Home situation Questionairre (HSQ-R)
- Strengths/Weaknesses of ADHD Symptoms and Normal Behavior (SWAN)
- Swanson, Nolan, and Pelham Rating Scale (SNAP-IV)
Determining Spectrum Disorders
Communication: Receptive, Expressive, Written Language
Daily Living Domains: Personal, Domestic, Community
Socialization: Interpersonal relationships, play and leisure time, coping skills
Motor Skills: Fine/Gross
Maladaptive Behavior: Internalizing, Externalizing, Other (sucks thumb, wets bed, etc)
Assessments in Determining Spectrum Disorders
Childhood Autism Rating Scale (CARS)
Autism Behavior Checklist (ABC)
Autism Screening Instrument for Educational Planning (ASIEP-3)
Autism Diagnostic Interview, Revised (ADI-R)
Behavior Observation Scale for Autism (BOS)
Gillian Autism Rating Scale (GARS-2)
Descriptive Classification of Intellectual Disabilities
Mild Intellectual Disability: 50/55 - 70
Moderate: 35/40 - 50/55
Severe: 20/25 - 35/40
Profound: below 20/25
**Never likely to evaluate someone with an IQ below 40
**IQ’s that are 49 and below require guardians
Developmental Delays
- Physical
- Cognitive
- Communication
- Social/Emotional
- Adaptive
Test Bias
Most significant problem with assessments with diverse populations
Difference in test scores that is attributed to demographic variables
Test Takers Bias
Found Components
- Language
- Test Wiseness: do NOT assume examinees can understand directions, comply with proper test-taking procedures, be involved and attentive
- Motivation/Anxiety: consider attitudinal characteristics
- Cultural Differences
Content Bias
Some content of psychometrics tools might not contain language that the test taker is familiar with
Examiner Bias Factors
Examiner MUST recognize personal bias and how it may influence interpretation of results
Instruments used for Giftedness
Scales for rating the behavior characteristics of superior studies (SRBCSS)
Gifted Rating Scales (GRS-S)
Gifted and Talented Evaluation Scale (GATES)
Screening Assessment for Gifted Elementary and Middle School (SAGES-2)
Cognitive Ability (CoAT)
Creative Thinking Ability (CoAT/TCTT)
Academic Ability (BASI)
Visual/Performing Arts
Assessment of Specific Learning Disabilities
Oral Expression: Convey ideas/inform verbally
Listening Comprehension: listen/understand words, questions
Written Expression: convey ideas/information in written form
Basic Reading Skills: ability to decode words
Reading Comprehension
Math Calculation
Math Reasoning: Applying math techniques and concepts
Instruments used in school assessment programs
Aptitude - Admissions Assessments (ACT, SAT, GRE, LSAT)
Achievement: MEAP, SAT, WRAT, Woodcock-Johnson, Wechsler Series
Career: Strong Interest Inventory, Self Directed Search
Purpose of planning of school assessment
to provide information needed to improve the public schools by enhancing the learning needs of all students and inform parents of the educational progress of their kids
Goals of school assessments
- Identify readiness of kindergarten and first grade students
- Determining whether students have mastered basic/essential skills needed by school system
- Placing students in educational programs
- Identifying students with special needs
- Evaluating the curriculum and specific programs
- Help students make educational and vocational decisions
- Assessing intellectual ability and aptitude of individual students
Cultural considerations in clinical assessment
- Test Bias: BIGGEST PROBLEM
- Content Bias
- Test Taker Bias
a. Language
b. Test Wiseness
c. Motivation/Anxiety
d. Cultural Differences
Assessment Therapy Acculturation
Common among second and third generations
Separating identity from parents
Assimilation
Etic
Universal qualities among humans by examining and comparing many cultures from a position outside of these cultures
Emic
Culture-specific and examines behavior from within a culture using criteria relative to the internal characteristics of the culture
Psychometrics
Branch of psychology that deals with design, administration, and interpretation of quantitative tests for the measurement of psychological variables such as intelligence, aptitude, and personality traits.
Neuropsychological Assessment
Testing for brain damage
Brain damage generally effects the cognitive functions - memory, speed in performing skilled activities or psychomotor and perceptual motor activities, auditory or tactile perception, and visual-spatial skills
Psychological Assessments
Use of tests or other procedures to gather information about an individual to aid in diagnosis, predict future behavior, determine CNS interviews
Suicide Risk Assessment
- Unstructured Interviews
- Suicide Intent: Present/recent suicidal thoughts)
- Details of plan: more specific, greater intent
- How they plan to die: means of death
- Lethality of means
- Accessibility of means
- History of suicidal thoughts
- Stability of current mood
- Family history of suicide attempts
- Assessment of warning signs
Warning Signs of Suicide
- Giving away possessions
- Putting personal affairs in order
- Radical changes in characteristic behavior/moods
Mental Status Exams
- Appearance, attitude, and motor activity: dress, grooming, signs of illness and behavior
- Mood and Affect: Range, lability appropriateness
- Speech: Quality
- Thought
a. Content: delusions, suicidal/homicidal tendencies, obsessions
b. Form: circumstantiality, tangentially, loosening of associations, flight of ideas, derealization, depersonalization, dissociative events, concreteness, grandiosity - Perception: Hallucinations and Illusions
- Cognition
- Insight
- Judgement
Complete MSE
a. Alertness
b. Orientation to time, place, person
c. Concentration
d. Recent/remote memory
e. Language
f. Calculations
g. Construction
h. insight/judgement
Advantages of DSM-IV-TR
Universal system used for diagnosis
Documents dialogue among mental health professionals
Requires clinicians to consider physical, psychosocial, environmental circumstances that influences the clients dysfunction
Multiaxial System
Axis I: Mental Disorders
Axis II: Personality Disorders and Mental Retardation
Axis III: General Medical Conditions
Axis IV: Psychosocial and Environmental Circumstances
Axis V: GAF
Global Assessment of Functioning Scores
Superior: 91-100
Absent/Minimal Symptoms: 81-90
Normal: 71-80
Mild Symptoms: 61-70
Moderate: 51-60
Serious: 41-59
Some Impairment: 31-40
Delusions/Hallucinations: 21-30
Aptitude Assessments
Predicts what someone is capable of doing with further training and education
IQ is only relative to the applications of knowledge
Achievement Assessments
Measures what an individual knows or can do in present
Ability to retain instructional information K-12
MEAP, SAT, WRAT
Wechsler Tests
WISC-III; WAIS-R; WPPSI-R
measures ability to reason, think abstractly, and solve problems
Intelligence Scales
Very Superior: 130+
Superior: 120-129
High Average: 110-119
Average: 90-109
Low Average: 80-89
Borderline: 70-79
Below Average: 69 and below
School ability and Intelligence
Wechsler Series
Kaufman Assessment Battery for Children (KABC-II)
Stanford Binet Intelligence Scale
Career Assessments
Strong Interest Inventory (SII)
Self Directed Search (SDS)
Unstructured Interviews
CNS made questions with “client responses” and “CNS observations” recorded by cns
no standardization of questions
No recording of client responses
Allows interviewee chance to direct session, Allows examiner to pursue unanticipated topics
Judge client behavior in unstructured setting
Structured Interviews
all questions asked to clients in same manner
ensures specific information collected from all clients
prescribed orders
