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Three Official Statements of the National Academy of Neuropsychology
The National Academy of Neuropsychology has quickly become the leading organization representing clinical neuropsychologists. Full membership is limited to individuals meeting clinical and educational criteria. The Archives of Clinical Neuropsychology, the official journal of this organization, and of which this writer is a member of the Editorial Board, recently published three position papers concerning issues frequently discussed/debated during matters of litigation involving neuropsychology. These three issues relate to third party observers during neuropsychological testing, the use of neuropsychology test technicians, and test security will be reviewed in this Legal Update. Readers interested in reading the complete versions of these papers are referred to Volume 15(5), July, 2000 of the Archives of Clinical Neuropsychology.
Presence of Third Party Observers During Neuropsychological Testing
Forensic neuropsychological evaluations are often constrained by a request/demand that a third party observer be present during the course of interview and formal testing. This demand often originates from opposing counsel’s goal to ensure that the neuropsychologist does not interrogate or unfairly question their client with respect to issues of liability as well as to ascertain that test procedures are accurately administered. However, neuropsychologists should have the right to carry out their examination in a matter that will not in any way jeopardize, influence or unduly pressure their normal practice.
The presence of a third party observer during the administration of any formal psychological or neuropsychological test is inconsistent with the recommendations of the standards for educational and psychological testing of the American Psychological Association and publishers of standardized instruments such as intelligence and memory scales. The presence of a third party observer is also inconsistent with the requirements for standardized test administration as set forth by the American Psychological Association’s Ethical Principles of psychologists and Code of Conduct.
There are likely circumstances that support the presence of a neutral, non-involved party in non-forensic settings. For example, students might be allowed to observe testing as part of their formal education. In some situations with younger children a parent’s presence during the evaluation of a child places the child at ease.
The National Academy of Neuropsychology Policy and Planning Committee concludes that “The weight of accumulated scientific and clinical literature with respect to the issues of third party observers in the forensic examination provides clear support for the official position.” Neuropsychologists should strive to minimize any influence, including the presence of observers that may compromise accuracy of assessments and “should make every effort to exclude observers from the evaluation.”
The Use of Neuropsychology Test Technicians in Clinical Practice
Neuropsychology technicians, also known as psychomotrists or psychological assistants, are individuals trained to administer and score a full range of neuropsychological and related tests. Many of these individuals are graduate students working to prepare for licensor. The practice of technicians is not unique to neuropsychology. Other doctoral level health care practitioners also routinely employ trained, non-doctoral technical personal.
Given that standards of practice exist for the selection, training, supervision, and utilization of neuropsychological technicians as defined by the American Psychological Association, the National Academy of Neuropsychology concluded that the use of technicians “is consistent with previously published American Psychological Association – Division 40 Standards for education, training, and supervision of non-doctoral neuropsychology technicians.
A major practice activity of neuropsychologists is the evaluation of behavior and functioning with neuropsychological tests. Many tests, for example those of memory or ability to solve novel problems, depend, to varying degrees, upon a lack of familiarity with test items. There is therefore a need to maintain test security to protect the uniqueness of these instruments. The need for test security is found across the board in education as well as psychological testing. This need is recognized as part of the ethical principles of psychologists and the Code of Conduct of the American Psychological Association.
In the course of the practice of neuropsychology, neuropsychologists may receive request from attorneys for copies of test protocols and/or request audio or video taped testing sessions. Copying test protocols, video and/or audio taping a neuropsychological evaluation for release to a non-psychologist violates the Ethical Principles of psychologists and the Code of Conduct of the American psychological Association by placing copyrighted, confidential test procedures in the public domain and by making tests available to persons unqualified to interpret them. Such requests can also place psychologists in potential conflict with state laws regulating the practice of psychology. Maintaining test security is critical due to the harm that can result from public dissemination of novel test procedures.
The Policy and Planning Committee of the National Academy of Neuropsychology recommends that a request to release test data or recorded examination places the neuropsychologists in possible conflict with ethical principles and directives. The professional “should take reasonable steps to maintain test security and thereby fulfill his/her professional obligations.” The committee recommends suggesting a compromise by offering to send the material to another qualified neuropsychologist or seeking a protective arrangement or protective order from the court. The Committee fully endorsed the need to maintain test security and viewed the duty to do so as a basic guideline for neuropsychologists. Nonetheless, they recommended that neuropsychologists “take appropriate and reasonable steps to arrange conditions for release that ensure adequate safeguards.”