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Tip of the Week

We periodically get emails and phone calls from people looking for answers about these issues. We have changed or taken out identifying details, and present questions and answers here that we hope will be useful to others.

Problem: Latino client does poorly across the board on cognitive tests, defense asserts "suspect effort" on tests rather than true disability.

Question:   How do I know if one of my clients is really disabled? Is English as a second language an issue I should pay attention to? One of my clients, a young Latino man, sustained a head injury in a car accident. His neuropsychologist assessed him using memory tests and a Spanish-language IQ test, concluding he was cognitively impaired. The defense expert assessed him using a test designed specifically for malingering. My client performed poorly on all the tests, including the malingering test. Given the pattern of test results, is it likely that this client is not really disabled?

Solution: Be aware that not all tests that are valid in Caucasian populations are valid for Latinos.

Answer:   No. In fact, your client may well be disabled, or might not be, but detailing that would require being assessed with tests valid for his ethnicity. Your client should probably be assessed by a neuropsychologist with expertise in testing clients whose first language is not English. Some further testing with tests that are definitely valid could be medically beneficial for your client to determine the nature of any deficits and the best rehabilitation plan.
     In the scientific literature, there is good evidence that one of the most commonly used malingering tests is not valid for use in a Latino population, so a different malingering test would need to be used.
     Furthermore, the scientific literature shows that not all Spanish-language versions of IQ tests are valid for calculating an IQ score. There are other "culture-fair" IQ tests that do not have such cultural bias.
     For the legal case, some well-placed questions to the defense expert, referring to the scientific literature, can help strengthen your client’s case; e.g.,
 - "I’m going to show you an article in this peer-reviewed, scientific journal, conducted by researchers who are experts in psychological assessment, just as you are, that concludes that this malingering test is not valid for Latinos. Can you show me any scientific research that suggests that this research reported here is not reliable?"
 - "Please show me in the test manual or published articles for [malingering test] the section explaining how this test has been validated on a Latino population, and what the scoring criteria are for Latinos assessed with this test." (There won’t be such a section.)

For archives of past "Tips of the week", click here.