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Clinical Psychological Service

Problems Usually Encountered when Reading Intellectual Assessment Report


When handling service applications of individuals with developmental disabilities, staff for rehabilitation services usually get access to the applicant’s Psychological Report or Intelligence Assessment Report. In reading the psychological reports, the staff will necessarily pay attention to the service user’s data like intelligence level, or other diagnosis and behaviour characteristics. However, the staff may also see a huge number of abstruse terms, data, and psychological concepts, and they may shy away from or be puzzled about them but do not know how to find references. I now briefly explain some doubts commonly encountered when reading psychological reports for your reference and comments.  


The Necessity of Re-assessment

Sometimes the staff may ask why some individuals with intellectual disabilities only need to have one intellectual assessment in their lifetime, while others need to have assessment twice or more? Generally, unless there are special pathological changes or brain injury, the intelligence of an adult will remain at a certain level for a long time. In other words, if a person once takes assessment in his adulthood, his assessment result will remain valid after several years, and he does not necessarily need another intellectual assessment. Therefore, a psychologist may refuse to make re-assessment, but suggest the staff refer to the assessment results in their past psychological reports.


But there are exceptions. For example, an individual with developmental disabilities had intellectual assessment during his/her preschool years (i.e. before 6 years old), he/she may be suggested to have a new intellectual test when he/she applies for the service after he/she enters adulthood. Moreover, a psychologist may consider having a new assessment to test the impact that some pathological changes may have on the functioning of an individual with intellectual disabilities.


Application of Assessment Tools


Psychologists have many intellectual test tools, which are generally developed with rigorous scientific methods and generate valid and reliable test results. Psychologists, according to their clinical judgments, use different tools to test the intelligence of individuals with intellectual disabilities or suspected individuals with intellectual disabilities. In testing high-ability service users, psychologists may use Wechsler Adult Intelligence Scale (WAIS), for which the third Chinese edition is available and applicable to adults usually. Staff may also get access to Hong Kong - Wechsler Intelligence Scale for Children in the Wechsler series which is applicable to local children. In testing average- or low-ability subjects, psychologists may use tools like Standford-Binet Intelligence Scale or Merrill-Palmer Scales of Mental Development. Of course, psychologists may only use one single assessment tool, or use several tools, to accurately assess the subjects’ intelligence level or satisfy the needs of referral according to clinical judgments, the special conditions of the service user (for example, concentration) or actual limitations.

Besides, a comprehensive intellectual assessment should also test the adaptive behaviours of individuals with intellectual disabilities with commonly used tools like Vineland Adaptive Behavior Scales and Scale of Independence Behaviors – Revised. Of course, different tools have different subtests, test batteries, test types, and scoring methods. I think that the staff may pay special attention to the overall interpretation that psychologists make for the test results.  


Categories and Differences of Test Scores

When reading psychological reports, the staff may notice piles of data, most commonly, Verbal IQ (VIQ), Performance IQ (PIQ), Full Scale IQ (FSIQ), Mental Age, etc., which are self-explanatory. But I think, if the staff want to know the essence of intellectual test results in detail, they should understand the difference in scores of the indices. As a psychological report generally lists FSIQ, VIQ, PIQ (and other indices), the staff should note whether significant differences / discrepancies exist between VIQ and PIQ, that is, whether they differ with each other by 15 or above. If so, it means the service user’s cognitive function may be of “clinical implications”, so they should pay attention to the explanation of the psychological report, and refer to the service user’s other information like personal development history. Moreover, the scores listed by FSIQ are not the “average scores” of VIQ and PIQ.


Some detailed psychological reports may set out the scores or profiles of all subtests, then the staff should pay attention to the significant differences / discrepancies between the scores (if any), and corresponding explanations. Some psychological reports may set out many confusing “scores” [such as scale score, raw score, and other indices], then the staff should refer to their scale scores, rather than raw scores, to compare the results of the subtests. However, psychological reports usually have analyzed those complex scores to explain the “characteristics”, strengths and weaknesses of the service user’s cognitive function.


Interpretation for Assessment Results

The author notes that some psychologists disagree that one index can reflect a person’s overall intelligence level. In spite of that, most people will only notice the subject’s FSIQ, as it can undoubtedly show the subject’s intelligence level or scope. But the staff should note that FSIQ is not a “test score”. For instance, Subject A gets an FSIQ of 65 while Subject B gets 61, this only indicates that they are all with mild intellectual disabilities, but doesn’t mean Subject A is “cleverer” or “more competent” than Subject B. Besides, an FSIQ of 64 in re-assessment by Subject B doesn’t necessarily reflect that Subject B becomes cleverer. Further more, some psychological reports only set out subjects’ mental age or age equivalent to assess their intelligence levels.


I once contacted some carers, who carefully trained their disabled children and found obvious progress in them. But, the carers were puzzled why their children showed even lower intelligence than before. Actually, a person’s intelligence is measured with reference to that of his peers instead of comparing his “competence” now with that in the past. For example, during the test when they were six, Subject C finished eight tasks (almost the same as those finished by children of the same age), while subject D only finished four. When they received the test again at 16, Subject D finished twelve tasks, while subject C finished 30 (almost the same as those finished by their peers, too). The results show that Subject D is indeed more “competent” than before. However, Subject D’s progress is lower than that of normal subjects of the same age. Compared with that of normal subjects, the relative level of the 16-year-old Subject D is even lower.



In fact, one purpose of the psychological report is to help us know more about the service user. I think it will help us better provide the service if the staff understand more about the contents of the psychological report. After all, the psychological report is written by professionals, who have indeed used lots of psychological knowledge and terms, for which I cannot provide comprehensive and detailed explanations here. It is best for the staff to consult the psychologist if they have any doubt about the psychological report.


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