American Psychological Association Division 40 (Clinical Neuropsychology)
Records
(Mss. 4745)
Return to APA
Collection Inventory Page
Copyright Restrictions
Image
file of document
Text of document:
In addition to formal university or college-based preparation, individuals
require training and instruction in numerous areas that pertain to their
role as a psychometrist. In addition to the learning of specific test procedures
(see below), the psychometrist-trainee must become aware of the goals of
neuropsychological examination and his/her specific role in achieving that
end. The psychometrist-trainee should also receive training in ethical
issues, methods of dealing with situations that arise in the context of
assessment, and specific instruction in regard to the limits of his/her
role, and relationships with the supervising neuropsychologist in addition
to other psychometrists. Each of these topics are considered below.
Administration and Scoring of Neuropsychological Tests
Without question the competence of the examiner is a critical aspect of
all assessment (Boll, 1981). In most settings, the most demanding technical
requirement for the psychometrist-trainee is to be thoroughly trained in
the specific assessment techniques advocated by the supervising neuropsychologist.
Psychometrists should be provided with manuals for each test which explicitly
define the instructions for administration and scoring. Many neuropsychologists
require that standardized test instructions be completely memorized. This
complete memorization enhances the efficiency of test administration, permits
the psychometrist to focus his/her attention on the patient, and may enhance
patient motivation and cooperation. Psychometrists should not be permitted
to administer any test to any patient until their mastery of instructions
for that specific procedure has been documented by the supervising neuropsychologist
(or in some cases a senior level psychometrist).
Extensive early practice administering tests to persons other
than patients is essential. In many cases, psychometrist-trainees learn
the various procedures in sequence so that they may begin to administer
a limited number of tests (on which their mastery has been documented)
to the patients being examined by other psychometrists while they learn
additional tests. In all cases, the administration of tests to patients
by new technicians should be closely supervised and monitored by the neuropsychologist
or a senior psychometrist with extensive experience in administration of
these procedures. At the completion of the training period, the supervising
neuropsychologist should provide written documentation for the psychometrists
file which indicates the nature and duration of training, and which indicates
that the psychometrist has satisfactorily completed the training program.
For all psychometrists, regularly scheduled follow-up supervisory sessions
should occur to ensure that standardized administration and scoring procedures
are maintained.
Psychometrist s role in achieving the goals of assessment
One typical goal of neuropsychological assessment is to determine a patient
s optimal level of performance on a particular battery of tasks. It. is
important that the psychometrist-trainee understand the philosophical goal
of the examination procedures. In addition to test administration, it is
typically the role of the psychometrist to establish rapport with the patient,
and to structure the assessment session to motivate the patient in order
to facilitate accomplishing the goal of the examination. Psychometrist-trainees
and new psychometrists should meet regularly with more experienced psychometrists
and/or the supervising neuropsychologist to discuss effective procedures
for establishing rapport and facilitating patient motivation and performance.
Ethics
It is the responsibility of the supervising neuropsychologist to provide
explicit guidance regarding ethical issues that pertain to their activities
in neuropsychological examination. These issues include (but are not limited
to) protection of patient confidentiality, protection of the confidentiality
of test information regarding patients, maintenance and protection of test
security, and constraints about dual relationships with patients (or supervisors).
The supervising neuropsychologist should provide access to the appropriate
APA documents, and may also find it helpful to develop a document describing
various ethical issues and the associated constraints these place on the
psychometrist.
Situations Arising in the Context of Assessment Sessions
Psychometrists may be working with patients who have a variety of neurological
or other medical conditions. It is important for the psychometrist to be
aware of appropriate institutional emergency procedures to deal with various
medical emergencies such as heart attack, respiratory arrest, seizures,
and so forth. In addition to medical emergencies, psychometrists should
be aware of recommended procedures for dealing with incompetent or adjudicated
patients who attempt to leave the testing setting without authorization.
Psychometrists must be trained to be sensitive to subtle or overt suicidal
or homicidal threats or innuendoes made during testing. Psychometrists
may also be exposed to aggressive or sexually inappropriate behavior on
the part of patients, and should be provided with specific instructions
on how to handle these situations. The very nature of the assessment situation
often elicits requests for information and reassurance by the patient in
regard to the adequacy of their performance. It is critical that psychometrists
understand the distinction between offering support or encouragement (which
is within their role) and evaluative feedback (which is solely within the
perview of the supervising neuropsychologist).
Limitation of the Psychometrists Role
It is essential that psychometrists have an explicit understanding of the
limited nature of their role in neuropsychological examination. The supervising
neuropsychologist must clearly delineate the lines of authority between
him/ herself and the psychometrist. The psychometrist should be made aware
at the time of their employment that their role in the overall process
is important, but nonetheless, by definition, is narrowly defined. As stated
in a previous Task Force Report, the role of the psychometrist is strictly
limited to the administration and scoring of certain test procedures that
are selected, interpreted, and communicated by the licensed neuropsychologist.
Similarly, psychometrists should be explicitly instructed not to present
him/herself to patients in a manner that implies any independent professional
prerogatives.
Some prospective psychometrists may inappropriately view employment
as an entry into the professional practice of neuropsychology. It is the
responsibility of the supervising neuropsychologist to correct any misperceptions
about the potential for growth in the roles and responsibilities of psychometrist.
It should be specifically stated that test selection, interpretation, or
communication of results are professional activities performed only by
the supervising neuropsychologist. It should be further stipulated
72
(End of text)
Footer
