By Michelle Grappo, MA, EdM, NCSP, IECA (CO)

Finding good psychoeducational and neuropsychological testing for native-English speakers in the United States is a difficult task. But if you work with international or multilingual clients, you know it can be a herculean task to acquire high-quality testing. Here are some questions to ask and homework to do when referring a client to a clinician for testing or evaluating testing already completed.

What are the clinician’s training and credentials?

Good testing begins with sophisticated and well-qualified evaluators. It goes beyond the hard data and scores to create a narrative that explains and describes a student’s strengths and weaknesses in a multidimensional way. The first step to good testing is ascertaining the assessor’s qualifications.

 

In my practice, I frequently see evaluators from abroad who have bachelor’s degrees or master’s degrees in fields that are unrelated to education or even psychology doing testing. As a point of reference, the United States tightly regulates who can administer and interpret cognitive testing (e.g., the Wechsler Intelligence Scales or similar). In most states, evaluators in private settings are required to have licensure and doctoral-level credentials. Master’s-level clinicians in private settings may sometimes administer testing but will likely have to be supervised by someone with licensure and doctoral-level credentials. School psychologists working in schools are typically allowed to administer cognitive testing and have extensive training in that domain. Notably, restrictions are looser for administering academic testing, and trained special educators and diagnosticians are frequently eligible to administer those measures in schools and private settings.

Is the testing comprehensive?

My training and philosophy—and by extension my educational consulting practice—lead me to take a whole-child approach. For educational and therapeutic planning, I look for testing that assesses three domains of functioning: social-emotional, cognitive, and academic. I have seen a lot of testing that just presents one set of scores, usually cognitive, with little explanation, background, or overall insight. In a word, that is insufficient. Comprehensive testing looks at the major areas of a child’s life, even briefly. For example, even if no social-emotional concerns are reported, it is best practice to administer at least one or two informal assessments, make inquiries with teachers and parents, and comment on those findings in the report.

Is the clinician familiar with the nuanced nature of bilingual testing?

Many graduate programs and postgraduate programs offer specialized bilingual evaluation training, which often culminates in endorsements or other credentials. Evaluating students from different cultures and backgrounds requires sophisticated techniques and experience. Even when testing in a child’s native language, we must consider whether the student has had sufficient exposure to certain concepts that are presented in cognitive and academic testing. For example, the WISC-V has French versions for Canada and France, but they would require caution for testing a French-speaker from one of the other 27 countries in the world for whom French is an official language.

Linguistic challenges can be further complicated by dual-language education and bilingual homes. I once had a client who had been raised in both English and Arabic. Because of a variety of developmental issues, his language acquisition was compromised equally in both languages, and testing had to be sensitive to those issues.

With what degree of sophistication does the evaluator describe linguistic and other limitations?

In an ideal world, we would conduct evaluations in a student’s native language, using measures that are standardized and normed in the native language. Indeed, that is possible for many students from around the world. The WISC-V (Wechsler Intelligence Scale for Children-Fifth Edition) is available in 32 versions, according to the Pearson Publishing website, and is one of the most widely translated cognitive assessments. There are multiple geographic versions for several major languages, for example four Spanish versions exist for Argentina, Chile, Mexico, and Spain. Other available versions include Arabic, Hebrew, Korean, Chinese, and even less-common languages, such as Danish, Hungarian, and Greek. Languages not available, but of note because they are widely spoken, include Hindu, Turkish, and Russian. Unfortunately, many measures have not yet been translated and, importantly, standardized or normed in many languages.

Given the limitations, however, we must manage in an imperfect world and begin with transparency. High-quality evaluators will recognize and identify the limiting factors—and the degree of sophistication with which that is done is telling. In the evaluation, they will spell out the linguistic limitations of the testing. They may also note methods that reduce linguistic demands. For example, they may choose measures that load less on language and culture. Or those measures may be administered only for qualitative—not diagnostic—purposes.

Testing can be highly valuable for the observations, process information, and qualitative information gathered. For example, a skilled clinician could collect information regarding a student’s behavior from teachers and parents and conduct classroom evaluations. Although he or she may not be able to make diagnostic recommendations, together with testing observations, the clinician could posit a case conceptualization (which could include further, more specific testing) and intervention recommendations. Some evaluators might employ new analysis methods that evaluate for cultural and linguistic differences in cognitive testing, such as The Culture-Language Interpretive Matrix (C-LIM) developed by Flanagan, Ortiz, and Alfonso (2013).

Is an interpreter an option?

Using an interpreter creates a nonstandardized setting and, therefore, limits the reliability and validity of test results. The use of interpreters, however, is not to be totally discouraged if they are engaged thoughtfully. Interpreters can be very helpful in communicating with families and students and assisting in collecting observations, input, and feedback. Well-trained interpreters can be especially helpful to ensure that directions are given accurately (e.g., on a nonverbal task). It is key that interpreters be coached and trained so that professionalism and objectivity are maintained. The use of peer translators or family and friends is not recommended. Again, a high-quality evaluator will openly discuss interpreters and the strengths and weaknesses of this input.

The Takeaway: Transparency and Value

This work is complex. When formulating case conceptualizations and guiding families, evaluators often walk the fine line of determining what is workable but imperfect information and what is simply inadequate or even inaccurate information. When parents come to me with poor-quality testing, I am transparent with them. I review many of the points I have outlined and explain what I look for in high-quality testing. I find it is helpful to emphasize that testing should be insightful and valuable. High-quality testing gives parents “aha” moments that address the referral concern and help explain how their child thinks, learns, and functions. It should be honest about scope and limitations and provide direction for additional assessment and interventions. It’s impossible to have perfect or even great testing, but we should aim for good testing that is child-centered, transparent, and valuable.

Michelle Grappo, RNG International Educational Consultants, can be reached at [email protected].