A colleague [Debs Viney] who is not on the dis-forum mail list has sent me
the following email as a contribution to this thread. I suspect Debs will
be attending the NADO conference so feel free to discuss her comments
directly with her.
David Grant, PhD., Chartered Psychologist
e-mail: [log in to unmask]
----------
>From: <[log in to unmask]>
>To: "David Grant" <[log in to unmask]>
>Subject: Re: Educational Psychologists reports for prospective students
>Date: Wed, Jun 25, 2003, 12:36 am
>
>Hi David
>
>
>I am no longer on dis-forum so please feel free to circulate these comments
>if you think they are a useful contribution to the debate.
>
>I am very concerned about the idea that people feel that the WAIS should not
>be restricted to Chartered Psychologists when used for the diagnosis of
>dyslexia (and I strongly agree with your point that this is only one of a
>range of specific learning difficulties which it could be used to help
>identify, in skilled hands, especially I would like to see more distinction
>between acquired and developmental SpLDs).
>
>To use a controversial analogy: this is like allowing a person who has only
>undertaken a one year part time counselling skills (say 140 hours like the
>one I did) course to "diagnose" psychiatric disorders! They might be
>familiar with the labels used, but they are not well-qualified enough to
>make the assessment and diagnosis safely - either for themsleves or for the
>patient. A psychiatrist has 5 years of medical UG training followed by
>years of post-grad clinical training....
>
>Firstly I must point out this decision is not ours to make in any case: the
>WAIS is owned by an American Company and they decide who can purchase and
>use it legitimately. They can and do "police" this, I believe that is right
>because such a test can be mis-used.
>
>But also I want to use my own experience to demonstrate a few things about
>the WAIS:
>
>I am a psychology graduate and I have a strong interest in psychometric
>instruments, so I took an extra interest in issues like validity and
>reliability when I was studying (and folks, I am feeling controversial
>tonight: if you are not ABSOLUTELY certain you know the difference between
>those and how they would / should be measured for a specific psychometric
>test, you should not be using any tests!).
>
>As a PG I took on a research job for which I was trained to use the WAIS as
>a research instrument - a set of measures of various cognitive functions,
>not for diagnostic purposes - I used it that way for more than 3 years
>during which I conducted hundreds of full WAIS assessments. But I am still
>not qualified to use the WAIS for diagnostic assessment and that is
>absolutely right. I do, through experience, understand much better than
>most people what the scores mean and how they can be interpreted, but I am
>in no way qualified to use this complex measuring instrument in any way
>other than the one in which I was trained.
>
>Therefore (in my opinion) anyone who believes that someone who has completed
>a relatively brief qualification specific to dyslexia should be allowed to
>make diagnoses using the WAIS is lacking in a grasp of why this test is
>valuable! It is the best instrument I have seen for this purpose, but it
>is still limited (inevitably) by the qualities and experience of the person
>using it.
>
>A further demonstration is that in the last few years I have seen examples
>of assessments conducted by a range of people (including, I regret to say,
>some Chartered Educational Psychologists and some people with RSA Cert / Dip
>qualifications) where people with other complicating conditions have been
>"assessed" and "diagnosed" as "dyslexic" WHEN THOSE COMPLICATING CONDITIONS
>HAVE BEEN BARELY MENTIONED AND CERTAINLY APPEAR NOT TO HAVE BEEN ADEQUATELY
>CONSIDERED AS POSSIBLE CONTRIBUTIONS to the specific learning difficulties
>which the student is experiencing. Those conditions have included: some
>visual impairments; severe brittle diabetes (constant fluctuations in blood
>sugar level would ineviatbly affect cognitive function in a range of ways -
>as I know from personal experience), and various forms of pre-existing brain
>damage (accident, surgical intervention etc.). I am not saying these
>students are not dyslexic, we cannot know without a more detailed assessment
>whichb addresses all of their history, I am saying that insufficient
>consideration was given to the other possibilities which could account for
>their symptoms - developmental SpLDs are a set of dysfunctions, acquired
>SpLDs even if they appear superficially similar, may not have the same needs
>or responses to specialist support.
>
>I have also seen the British tests of various sorts used without
>acknowledgement of the limitations for students whose first language is not
>English (which invalidates any results unless you have test norms for
>non-English speakers). I've seen adults tested on instruments where the
>age ceiling is 14 years...again without justification or comment. I've also
>seen a few false positive and false negative test results from various
>tests.... Etc., etc......
>
>A couple of further thoughts: if you want to be able to make "dyslexia
>diagnoses" you will need to feel confident and competent enough to stand up
>in court and answer cross-examination by an opposing barrister if you get it
>wrong and the student sues you (whether they sue because you said they were
>dyslexic, or because you said they were not). A Chartered Psychologist
>should be in that position (a good training or CPD would have covered the
>skills for that too!) .... would someone with a lower level of qualification
>be that confident?
>
>Finally I think one of the most important reasons for using a qualified Ed
>Psych (or Neuro Psych or Occupational Psychologist come to that) is that
>they are at least reprepsented by a single national profssional body - the
>applicable division of the British Psychological Society. This means that
>if you are dissatisfied with a Chartered Psychologist's work, or their
>ethics, or whatever, you have a place to complain to and they have formal
>procedures which can be followed. That is quite a lot of cover for YOUR
>back, if you let the Psychs do the diagnosis colleagues!
>
>I want to point out that my comments are not intended as personal criticism
>of any of my colleagues - the examples I have cited are likely to be
>replicated in other institutions.
>That's enough controversy for tonight!
>regards, Deb
>
>
>Deb Viney
>Personal email account
>
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