During our recent PARtalks webinar series on assessing individuals with disabilities, PAR received some questions about adapting, modifying, and accommodating assessments. It is important to be mindful of a range of psychometric, social, clinical, and disability-related issues. We hope the following will provide helpful guidance when determining if modifications or accommodations are necessary.
There are many issues to consider that may complicate the psychological testing of people with disabilities. It is important to attend to issues of bias, reliability, and validity.
Language, motor, sensory, medical, and cognitive disabilities can impact aspects of an assessment. Additionally, comorbid conditions or secondary disabilities can be a complicating factor.
It is crucial for examiners to consider each individual's disability and how it relates to other functions to develop a strategy that ensures the appropriate construct is being measured. For example, disability-related symptoms such as fatigue and pain can confound psychometric tests and artificially inflate measures of depression. Or a motor-functioning disability that affects fine motor control may create results that mistakenly imply cognitive impairment. Examiners who do not take these issues into consideration risk drawing misleading inferences, making inaccurate conclusions, and offering unsuitable treatment recommendations.
To determine if an instrument is suitable for use with a client with a disability, clinicians must evaluate if the measure(s) being considered are appropriate for use without introducing accessibility challenges. If the construct to be measured will be measured in a way that requires a specific functional ability that is related to the client’s disability, or if the measure’s administration instructions and response options are related to the client’s impairment, for example, another measure may be considered.
The clinician should consider validity information regarding a measure’s use with people with specific disabilities, just as they would for any other population. Quantitative measures should be supplemented by qualitative and functional assessments. Before testing, it is important to meet with the client to understand disability-specific characteristics related to the constructs of interest. It is the clinician's responsibility to describe the assessment and subsequent results in terms that the client can easily understand.
Any decisions to modify protocols requires thoughtful consideration and justification but may be useful ways to support individuals with disabilities. There are two types of alterations to testing, accommodations and modifications. Accommodations improve access to the test without affecting the construct being measured. Modifications may affect the construct and may influence validity.
Accommodations: A testing accommodation is a change in test format, presentation, administration, or response procedures. Accommodations do not alter the construct being measured and scores are comparable with the original test.
Modifications: Modifications are testing changes that may alter the intended construct. The purpose of a modification is to improve accessibility while retaining as much of the original construct as possible.
Accessibility means the ability to access, interact with, and respond appropriately to test content. It involves designing a measure in a way that reduces barriers to a valid assessment of a given construct. Accommodations and modifications are often made to increase accessibility, but if accessibility is designed into the structure of an instrument, they may not be required.
Determining the necessity of an accommodation depends on how the disability presents as well as the construct or constructs being assessed. Accommodations help clients with varying levels of ability by removing access barriers that might influence the individual’s results. However, accommodations do not alter the construct being measured.
Accommodations may be made to the environment or to the way a task is presented without changing the content of the task. An accommodation for a student with a visual impairment might be enlarging print materials; an accommodation for a student who is deaf might be providing an ASL interpreter.
Modifications, however, can be changes that are made to the content or expectations of an assignment, task, or assessment. A student with a learning disability might receive a modification that reduces the number of questions on a test or provides untimed access to the materials. Modifications change what the individual is expected to learn or do in order to make it more accessible.
In general, modifications are more significant changes. Modifications alter what is expected of the individual; accommodations are less significant changes that provide support for the individual to access the same content and activities as their peers.
Learn more about modifying psychological assessments for individuals with disabilities:
American Psychological Association (APA) Guidelines for Assessment and Intervention with Persons with Disabilities: APA has developed these guidelines to help psychologists develop and implement effective, fair, and ethical psychological assessments and interventions.
National Joint Committee on Learning Disabilities (NJCLD): The NJCLD has developed guidelines for the assessment of individuals with learning disabilities. The NJCLD offers recommendations for modifying psychological assessments.
National Association of School Psychologists (NASP): NASP offers advice and guidance on modifying assessments as well as evaluating the effectiveness of those interventions.
The PAR Training Portal. Catch up on the PARtalks disability series on the PAR Training Portal. Recorded webinars are available on demand to help you learn more about working with individuals with a variety of disabilities.
This week’s blog was contributed by Nikel Rogers-Wood, PhD, LP, HSP. Dr. Rogers-Wood is a licensed psychologist and a project director at PAR. She has a PhD in counseling psychology.
“I’ve been feeling really anxious, my heart races, and I can’t concentrate. I already know I have generalized anxiety disorder because I watched a bunch of TikToks and took a quiz online that came back with a diagnosis.”
Sound familiar? Social media, particularly TikTok, is a place where clients and potential clients sometimes go to find answers to their mental health questions. Though it's encouraging to see more social acceptance and support for mental health challenges, there are so many influencers out there that it can be difficult to know who has professional expertise and what information is accurate.
Further complicating the situation are online quizzes. Type “Do I have depression?” into Google and get pages of results. Many of these quizzes also show up as ads and links embedded in social media feeds. What differentiates these free social media quizzes from well-researched and empirically validated tests? A great deal. Can the general public tell the difference? Not yet. That’s where PAR can help.
As one of our assessment customers, you already know the value of an accurate evaluation. After all, quality assessment results in accurate diagnosis, which drives effective treatment and positive client outcomes. That’s why it’s so important for clients to seek testing and support from qualified professionals. So how do you help someone who has self-diagnosed find their way to more accurate and helpful information?
The first step is to validate what they’re seeking—answers. Something is happening in their lives that has driven them to find the answer on the internet. However, much like it's hard to find the right street when your GPS is programmed to another part of the country, it’s hard to find answers when you take a quiz that isn’t reliable or valid.
It’s important to educate our communities so they realize that building a good assessment measure goes beyond choosing questions to ask. They need to know that researchers and test publishers devote time and energy into determining whether individual items (and the test as a whole) measure what they are supposed to measure; if there are differences in outcomes based on demographic factors like age, sex, and race/ethnicity; if the results can be trusted to be reliable; and how the results fit in with diagnoses. Although it may be tempting to take a free quiz that pops up on our social media feed, when it comes to our mental health, wouldn’t it be better to find a resource that will give us accurate results?
PAR provides a wide variety of high-quality assessments that have been well built, validated, and thoroughly researched. We also offer our products in performance-based and self-report formats. For individuals who prefer a self-serve style of assessment, the Self-Directed Search asks questions about career interests and preferences and produces a thorough, client-friendly report with results and guidance on next steps. When a deeper dive is necessary, individuals can collaborate with a licensed professional and use an instrument like the PAI for answers.
The difference between unvalidated quizzes and validated assessment measures is the difference between cookies and a real meal. Can you eat either one when you’re hungry? Sure. However, the cookies only take the edge off hunger and your nourishment can’t be based on cookies alone. At PAR, we offer the five food groups. Snacks aren’t going anywhere, but when you want to get what you really need, come to us.
This week’s blog was contributed by Maegan Sady, PhD, ABPP-CN. Maegan is a project director in PAR’s research and development department in addition to being a licensed psychologist and board-certified neuropsychologist. She worked as a pediatric neuropsychologist for nearly a decade before joining PAR.
Add trauma screening to your evaluation checklist
Assessment clinicians are trained to look for hidden problems, and we all know the common ones. If a child comes in with a referral for an ADHD evaluation, we screen for anxiety and sleep problems. When an older adult complains of memory problems, we inquire about symptoms of depression. There’s a new kid on the block, though—trauma. Trauma isn’t new, of course, but more clients may be experiencing its effects along with whatever brought them to you for assessment.
Expanding the definition of trauma
Trauma is a broad term for experiences that are dangerous or threatening. Although abuse or violence quickly come to mind, experiences of losing a loved one, food insecurity, or chronic social isolation can just as readily result in symptoms. The COVID-19 pandemic has increased these experiences, and some argue the pandemic itself may be a form of trauma. The impact of multiple stressful events—say, experiencing displacement due to a wildfire during the pandemic—can be multiplicative. Similarly, existing health and economic disparities have been exacerbated by pandemic-related stressors.
Screening for trauma
Because traumatic experiences have increased, it makes sense that more clients are experiencing trauma effects. Trauma symptoms can mimic other disorders, including anxiety, depression, and even psychosis or personality disorder. Untreated, trauma effects can negatively impact physical health and lead to higher rates of suicide and substance abuse.
To decrease the chance that you miss trauma as a comorbid cause of your client’s problems, make it routine to ask about trauma history. A written checklist (e.g., the Adverse Childhood Experiences Questionnaire) can help clients feel more comfortable disclosing their history. Unless you are specifically trained in trauma-related care, do not ask your client for details, but assure them you will provide resources.
If there is a positive history of trauma, assess for associated symptoms to guide recommendations; structured checklists can identify the severity and breadth. No matter the age of the client, PAR has you covered with the TSCYC, TSCC, TSI-2, FACT, and the DAPS. When time is short, screening versions are also available for most of these measures. And because many digital options are available on PARiConnect, it's easy to add a variety of administrations to your inventory when you need them.
Referring for additional assessment or treatment
When trauma is a contributing factor for your patient, you can provide a referral for evidence-based treatment and/or educational resources. For children, the American Academy of Child and Adolescent Psychiatry and The National Child Traumatic Stress Network have handouts and book recommendations. For adults, visit the National Center for PTSD. For individuals of all ages, see the website for the International Society for Traumatic Stress Studies.
Making trauma screening a routine part of your clinical assessment may uncover important treatment targets, helping your client deal more effectively with their original presenting concerns.
Each year, International Women’s Day is celebrated on March 8, recognizing the social, economic, cultural, and political achievements of women around the world. The day is also an opportunity to raise awareness of the challenges and inequalities that women face and to advocate for gender equality.
It is no secret that women have historically faced greater barriers than men when it comes to fully participating in the economy. Disparities between men and women persist in the form of pay gaps, uneven opportunities for advancement, and unbalanced representation in important decision-making. Although women represent 58.4% of the U.S. workforce as of September 2022, women only represent 35% of senior leadership positions. And while 82% of Americans say it’s important that men and women have the same career opportunities, only about a third of Americans say their place of business prioritizes putting women in leadership positions.
Here at PAR, we are proud to have a staff that is 60% women. When we polled our staff to ask about women coworkers whose work deserved to be acknowledged publicly, the response was overwhelming—citing women who inspired them in their day-to-day life, those who were contributing their time and energy to charities and causes, those who had faced personal struggles, and many who had celebrated incredible achievements. We are so proud to work among such women today and every day.
Recently, PAR added several new features to the PAI Plus reports on PARiConnect. As a result, we have received a few questions about how to use the Negative Impression Management (NIM) and Positive Impression Management (PIM) predicted profile overlays as well as the NIM- and PIM-specific profiles. We went directly to author Leslie C. Morey, PhD, to get his answers on how you can use these features to enhance your understanding.
LM: NIM and PIM predicted profile overlays are regression-based predictions of the profile based on information from the validity scales. These profiles represent one strategy for understanding the influence of the response styles represented by the validity scales, NIM and PIM. In this approach, PAI scale scores are predicted solely by either NIM or PIM, using a regression model based on the correlations observed in the standardization samples. Thus, these profiles are not based on data from the profile of the individual being assessed, with the exception of their NIM or PIM scores. The resulting profile constitutes what would be expected given the observed score on NIM or PIM. The contrast between observed (i.e., the respondent’s actual PAI profile) and predicted profiles indicates the extent to which scale scores are expected to have been influenced by response set distortion. If the observed and expected scores are comparable (e.g., within one standard error of measurement), then the scores can be largely attributed to the effects of whatever led to the observed response set, such as potential exaggeration or cognitive distortions.
LM: The NIM- and PIM-specific profiles represent another strategy for understanding the influence of any observed response styles on the PAI profile. However, instead of predicting every score on the rest of the profiles, it compares the observed profile to a group of profiles from the standardization samples that displayed a similarly elevated score on PIM or NIM. This strategy then calculates standard scores for the individual’s observed scores based on the means and standard deviations of similarly distorted profiles. Thus, elevations indicate psychopathology above and beyond response sets. Unlike the predicted scores, which tend to yield greater variability in predictions for negative impression management than for positive impression management, the specific score strategy is equally useful in understanding the influences of both types of response sets.
Two groups are used for comparison purposes on the NIM- and PIM-specific scores, as defined by two ranges on these scales. The first group, the lower range, is based on cutoff scores determined to have maximal efficiency in distinguishing impression management from genuine groups. For NIM, this range is 84T to 91T; for PIM, it is 57T to 67T. The second group, the higher range, is equivalent to scores that equal or exceed two standard deviations above the mean in a clinical population: 92T for NIM and 68T for PIM. No specific scores are generated if NIM is less than 84T and PIM is less than 57T.
Read more about how the NIM scale can be used to assess malingering.
This year commemorates the 100th anniversary of one of the most widely used tests ever published—the Rorschach Test. We take this opportunity to look back on the history of this assessment and the person who made it possible.
Hermann Rorschach was a Swiss psychologist and psychiatrist who is best known for developing the Rorschach inkblot test. He died in 1922 at the age of 38—before the test gained popularity. This projective test was never intended to be what it is today. In fact, initial research was focused on using this as a test for schizophrenia.
As a child, Rorschach was a fan of a game called Klecksographie. He was so devoted that his childhood nickname was Kleck. The game involved collecting inkblot cards and using those cards to create stories based on your interpretation.
Rorschach's early training was in psychiatry and psychoanalytic theory, and he became interested in the use of projective techniques. During his training, he noticed that individuals who had schizophrenia made different associations with the Klecksographie cards than those individuals without schizophrenia. He believed that the human mind projects its own subjective interpretations onto ambiguous stimuli, and these projections could reveal important information about an individual's personality and emotional functioning.
Rorschach studied 405 subjects, 117 of whom were not psychiatric patients. He showed each person a card and asked them what it may be. After four years of research, he believed this test could help diagnose and assess mental illness.
His results were published in 1921. The test gained popularity in the years following Rorschach's death, becoming the most popular test in clinical practice in the U.S. following World War II. It remains one of the most widely used and well-known psychological tests to this day.
The Rorschach test consists of 10 psychodiagnostic plates, which are presented to the subject one at a time. Though the test was initially designed for adults, normative data is available for adolescents and children.
After administration, the subjects’ insights and reactions are recorded and analyzed. In addition to scores, interpretation of behaviors during testing, patterns of responses, and themes may be taken into account.
Rorschach established a parallel between a mostly global approach to the blots and the ability to synthesize versus a more detailed approach reflecting a more analytical mind. He also determined that it was important to attend to an individual’s sensitivity to grey and black colors as well as the proportion of objects. Through this work, Rorschach proposed a typology distinguishing three basic modalities of relating to the world: introversiveness, extratensiveness, and ambitancy. These types relate to the way people associate, dissociate, or mix emotions and thoughts.
The validity of the Rorschach Test has been challenged over the years, and much research has been dedicated to both the criticism and support of the measure. As Rorschach died before the test achieved notoriety, much of the work has been done by others, and there is concern that other researchers may have modified or reinterpreted the assessment. The International Society of the Rorschach and Projective Methods (ISR) encourages users to only original stimulus material to maintain the integrity of the test.
The ISR produces the journal Rorschachiana that publishes the theory and clinical applications of the Rorschach and other projective techniques. You can read its latest issue here.
The Rorschach Test Centenary Edition is now available. It includes the original test plates, a newly translated and annotated edition of the original book, and a special issue of the Rorschachiana journal that addresses recent studies on the reliability and validity of the test.
In honor of Black History Month, it is important to acknowledge that the accomplishments of Black Americans have too often been overlooked. We would like to take this opportunity to recognize several notable Black psychologists who are responsible for historic contributions to the field. These individuals and their work deserves to be amplified in order to build a future based on equity, inclusion, and opportunity.
Dr. Beckham is known as the first African American to hold the title of school psychologist. He established the first psychological laboratory at Howard University in Washington, DC. He is also credited with starting the first psychological clinic in a public school at DuSable High School in Chicago.
Dr. Canady is most known for being the first psychologist to study how the race of a test proctor may create bias in IQ testing. He found that the rapport between examinee and examiner could have significant impact and provided suggestions to reduce bias.
This husband-and-wife team are known for their famous “doll study,” which showed that Black children, when asked to choose a doll most like themselves, would disproportionately choose White dolls. Their research was used in Brown v. Board of Education case in 1954 to argue that racially separate schools were psychologically harmful and violated the 14th Amendment.
Dr. Prosser was the first African American woman to receive her doctoral degree in psychology. She spent most of her short life focused on teaching and education.
Dr. Prosser's dissertation research focused on self-esteem and personality in matched pairs of Black students, with half of those studied attending segregated schools and the other half attending integrated schools. She found that Black students fared better in segregated schools. Her findings were controversial in the years leading to Brown v. Board of Education but were supported by people such as Carter Woodson and W.E.B. DuBois.
Dr. Sumner was the first African American to receive a PhD in psychology. His research focused on understanding racial bias and encouraging educational justice. He was one of the founders of the psychology department at Howard University, where he served as chair from 1928–1954.
PAR staff has arrived in Denver and we are so excited to see you at the NASP 2023 Annual Convention!
Make sure to stop by the PAR booth and save 15% on any purchases made at the convention. You will also receive free ground shipping!
PAR authors and experts will be presenting throughout the conference. Be sure to check out these informative sessions.
Assessing Written Language Disorders Using the FAW: Interpretive Report and Interventions
Steven G. Feifer, DEd, and Carrie Champ Morera, PsyD, NCSP, LP
PAR Publisher Sponsored Special Session
Wednesday, February 8, 9:00–9:50 a.m. MT
Evidence-Based Assessment With the BRIEF2 to Identify Students With ADHD
Peter K. Isquith, PhD, Gerard A. Gioia, PhD, Steven C. Guy, PhD, and Lauren Kenworthy, PhD
Thursday, February 9, 8–9:50 a.m. MT
Executive Functioning Challenges and Interventions for Students With ASD or ADHD
Lauren Kenworthy, PhD
Thursday, February 9, 8–9:20 a.m. MT
The Neuropsychology of Stress and Trauma: Developing Trauma Informed Schools
Steven G. Feifer, DEd
Thursday, February 9, 10–11:50 a.m. MT
Using Neuropsychology to Identify Dyslexia in Spanish and English
Steven G. Feifer, DEd
Thursday, February 9, 2–3:50 p.m. MT
Looking forward to seeing you in Denver!
This week’s blog was contributed by Melissa Milanak, PhD, PAR’s clinical assessment. Melissa is a licensed clinical psychologist and internationally recognized academic. She has extensive clinical experience providing therapy and conducting assessments with a diverse array of patient populations.
As your trusted source for assessments for all your clinical needs, PAR is excited to also partner with you in many practical ways as you conduct your research, whether it be a large federally funded grant, a manuscript you are preparing to submit, or a course project with your students and trainees running on zero budget. Here are just a few of the ways PAR can help researchers.
The submission deadline is approaching, and it is time to write the methods section. Instead of spending hours pouring through assessment manuals and reading journal article after journal article to extract psychometric data for the one paragraph, consider reaching out to PAR directly. Our psychologists and researchers have already prepared and formatted the assessment info paragraphs for you that you can insert into your manuscripts and grant applications. Don’t see the one you need there? Let us know and we will get you the info you need.
Through our data sharing program, you can partner with our R&D team to help us collect important data on our assessments all while receiving discounts and/or free usage of the related assessments. All data sharing is of course de-identified and confidential to protect participants.
Through our digital assessment platform, PARiConnect, you can email HIPAA-compliant links directly to research participants to complete all of your research assessments online, expanding your geographical reach. You can also access observer and collateral research data without requiring additional individuals to come into your data collection site. Plus, if you send out an assessment link and a participant decides not to participate, you can revoke the link and reuse the assessment with another participant without having to pay for an unused assessment.
By using PARiConnect, either through a HIPAA-compliant email link or in-person digital entry option, participants enter their own data, removing a layer of data entry error (and the need to invest in time for research assistants to enter and check data entry). Plus, with settings to prevent skipping questions, you can reduce the risk of missing data.
In less than a minute, you can download item-level assessment data to a CSV spreadsheet formatted to integrate with statistics software such as SPSS to increase the ease of data processing and analyzation.
Through our FREE Training Portal and team of clinical assessment advisors, PAR provides on-demand training for you and your research teams to learn about the assessments from underlying constructs to administration, scoring, and interpretation.
As you are designing your research, clinical psychologists, neuropsychologists, and psychometrists who have a history of successfully securing federally funded grants and publishing in high impact-factor journals are available to consult with you to build effective, efficient research assessment batteries.
These examples are just the beginning when exploring ways that PAR can partner with you to design, conduct, and publish your research using high-caliber, industry gold-standard assessments. Reach out to our team today to learn more!
Check out this video on ways PAR can help you easily integrate digital assessments into your practice.
This week’s blog was contributed by Terri Sisson, EdS, educational assessment advisor, national accounts. Terri spent more than 20 years in public schools as a licensed school psychologist. She is a past president of the Virginia Association of School Psychologists.
Many students with executive function deficiencies find their performance in both the home and classroom environments is negatively impacted. When I practiced in the schools, I wrote my recommendations with parents and teachers in mind, as these were the people who would read and use my recommendations. I found that if the intended audience understood executive functions and how they impact learning, they were more likely to be effective at implementing successful strategies.
Lauren Kenworthy, PhD, coauthor of the Behavior Rating Inventory of Executive Function, 2nd Ed. (BRIEF2) and the Unstuck and on Target! curriculum, and her colleagues have created a free video series designed for parents and teachers that explains different executive function concepts and provides recommendations for intervention.
Some videos are designed specifically for teachers and offer free training (with continuing education credits). For parents, informative videos and tip sheets help explain the executive functions in a way they can easily understand. Some videos are available in Spanish.
Although the videos support the Unstuck and on Target! curriculum, which improves flexibility, planning, organization, problem solving, and coping, they provide useful information for all parents and teachers about how to improve executive functioning in students. Check out the videos for teachers or parents and share them with others who may benefit.
Learn more about Unstuck and on Target!