Assessing Adolescents in Educational, Counseling, and Other Settings

Robert D. Hoge

• Publisher: Routledge
• Year: 1999
• eBook ISBN: 9781135674465
• Topic: Psychology
• Subtopic: Clinical Psychology
• Index: Psychology

Adolescence is a distinct period of development that presents a number of special challenges. This fact has important implications for professionals selecting and administering assessment procedures and interpreting the data they yield, yet assessment texts have focused on adults or children and devoted minimal attention to adolescents. This book constitutes the first up-to-date and practical guide to the effective psychological assessment of adolescents.

Throughout, the author's emphasis is on standardized instruments. Their use, he argues, provides more valid information about individuals, leads to better treatment or placement decisions, and contributes to the more efficient management of organizational resources than does reliance on clinical interviews and judgment alone.

Assessing Adolescents in Educational, Counseling, and Other Settings will be welcomed by all those professionally involved in the assessment of adolescents--psychologists, psychiatrists, social workers, child care agency staff, and educators--as well as by those who must make decisions based on their assessments--school principals, youth court judges, and managers of residential treatment facilities among others. Developmental researchers will also find this review of available standardized tools helpful in their work.

1
Introduction

This book is based on three key propositions. First, the effectiveness of any educational, therapeutic, or counseling intervention depends at least in part on the quality of the assessment on which it is based. For example, a decision to provide a youth with a program of behavior modification treatment for depression would be appropriate to the extent that it reflects the actual emotional state of the youth and other characteristics that would affect his or her reactions to this treatment. Similarly, the ultimate success of a decision to counsel a youth to follow an academic stream in secondary school will be limited by the accuracy of the initial assessment of the student’s aptitudes and interests.

Second, standardized psychological assessments and structured diagnostic procedures are more likely to yield valid information about an individual than the informal and unsystematic assessments so often employed in clinical, counseling, and educational settings. There is certainly a role for experienced clinical judgments in the treatment of clients, but, as I try to show in later sections of the book, standardized psychological assessments provide a firmer and more defensible foundation for diagnostic and decisionmaking activities.

Third, assessment tools and procedures should be appropriate for the individual being assessed. I have chosen in this book to focus on the assessment of adolescents because I believe that this group often exhibits characteristics and circumstances that set them apart from children and adults. Further, these unique features mean that, in many cases, assessments and interventions appropriate for younger and older age groups may not be indicated. This point is reinforced in the discussion of theory and research on adolescence that follows.

DEFINING ADOLESCENCE

The terms adolescent and adolescence are ubiquitous in our language, and we use them with absolute confidence. However, closer examination reveals a great deal of ambiguity in their meaning, and, in fact, historians and social scientists have argued for a very long time over alternative definitions of the construct.

The word adolescence derives from the Latin adolescentia, which refers to the process of growing or growing up. It does not have any referent to an age range in Latin, but the Oxford English Dictionary indicates that it first appeared in English in the middle of the 15th century as a term referring to a young man. The current use of the term to refer generally to the teen years apparently evolved from that time.

We do generally refer to the teen years as the period of adolescence and a youth in that age range as an adolescent. However, establishing more precise criteria for defining this developmental period is quite difficult.

One approach to definition is in terms of physical development. In this case the beginning of adolescence is said to correspond to the onset of puberty when primary and secondary sexual developments make their first appearance. This process is guided by hormonal changes and accompanied by other significant physical changes. I show later in this volume that the physical events associated with the progress toward sexual maturity do have important consequences for the development of youth during the early years. On the other hand, there are some problems with using these physical changes to delimit the period of adolescence. First, there is considerable variability both between and within the genders with respect to the period of onset of puberty. Menarche, for example, may appear as early as age 9½ in some girls and as late as age 16½ in others. Further, the age of onset of puberty is generally about 2 years earlier in girls than boys. Second, delineating the end of the adolescent period by the achievement of sexual maturity is not particularly meaningful. Most young people achieve sexual maturity before what we would consider emotional maturity. Third, many of the psychological processes popularly associated with adolescence do not relate in any direct fashion to the onset or achievement of sexual maturity. For example, the beginning of dating behavior, typically associated with early adolescence in Western society, sometimes appears before any signs of sexual development.

A second approach to definition of adolescence is in terms of singular psychological processes that appear to mark a transition from childhood at one extreme to adulthood at the other. Certainly there are popular assumptions in this regard. Thus, the onset of adolescence is presumably marked by efforts to achieve independence from adult influence, to form a stable identity, to develop a gender role, and by other processes and events thought unique to this age period.

There are some problems with this approach as well. One difficulty is that there is no real agreement over the nature of these psychological processes. Rather, as I address in chapters 2 and 3, a variety of hypotheses have been advanced. This variety makes it nearly impossible to develop an explicit definition of adolescence purely on the basis of psychological processes. A second difficulty is that the psychological approach has tended to ignore the operation of historical and social forces. We now know that this is a mistake. It is clear that the psychological experiences of youths (and even their physical development to some extent) are very much affected by their social environment. The dynamics of home, school, and community have a very direct impact on the course of their psychological development:

Adolescence (or the broader category of youth) can be fully understood only when viewed within the life course and its historical setting. Each generalized stage, or age category, is constructed from norms and institutional constraints that establish a basis for identity and specify appropriate behaviors, roles, and timetables. (Elder, 1980; p. 6)

This also means that the nature of the adolescent experience will vary across time and across cultures. Therefore, the search for a universal psychological definition of adolescence is complicated.

In spite of these reservations, I show in chapters 2 and 3 that continuing efforts are being made to discover and analyze physical and psychological processes particularly relevant to youths in the teen years. For the purposes of this book, then, the term adolescence will generally be used to refer to the period from 11 to 19 years of age, but we must keep in mind the limitations associated with any efforts to generalize across all youths within that age range.

NATURE OF THE ASSESSMENT PROCESS

We tend to take for granted assessment activities, but it should be understood that they underlie all decisions about individuals and the quality of our assessments places limits on the effectiveness of our decisions. These issues are explored in chapters 4 and 5, but some introduction to the main points is appropriate.

The assessment process involves three steps: (a) the collection of information about an individual, (b) the translation of that information into an inference or judgment, and (c) the use of the inference or judgment as the basis for a decision. The inferences or judgments are often referred to as assessments or diagnoses. These are sometimes expressed in qualitative terms as, for example, where diagnostic categories such as attention-deficitdisordered, severely depressed, or developmentally delayed are employed. In other cases the judgment may be expressed in quantitative terms. Thus, the youth is characterized as above average in mathematics aptitude or at the 30th percentile with respect to an index of conduct disorder. In still other cases the judgment is expressed in terms of a predictive category. For example, the youth is judged at high risk for delinquent behavior, at moderate risk for academic problems, or with a high likelihood of succeeding in a program for the gifted.

Varying levels of structure may be imposed on both the information collection and inferential components of the assessment process. In many applied situations both the information collection and diagnostic processes are based on informal and unsystematic procedures, and are referred to as clinical assessments or diagnoses. An example would be a school psychologist who informally examines a boy’s work, consults with his teacher, and diagnoses him as learning disabled. Another might be a therapist who conducts an unstructured interview with a client and diagnoses depression. The information is being collected in these cases through informal procedures, and the inference or judgment about the client is based on an intuitive process utilizing the clinician’s education and experience.

The alternative is to base the information collection and diagnostic processes on standardized psychological assessments. The latter may be defined as instruments or procedures with (a) fixed stimulus, response, and scoring formats (b) that yield quantitative scores and (c) for which normative and psychometric data are available. These are also sometimes referred to as objective or psychometric assessments, although some ambiguity is associated with those terms.

An example of a standardized assessment would be the use of a standardized intelligence test to collect information about cognitive performance and provide a quantitative index of cognitive potential. The latter represents the inferential or judgmental phase of the process. The use of a standardized teacher rating measure to collect information about classroom behavior and form an inference about behavioral pathology is another example. The information is being collected and the inference or diagnosis formed in these cases through standardized procedures.

It should be recognized that the line between clinical and standardized assessments is not always entirely clear. Clinical assessments may be based in part on standardized assessment tools. For example, mental health professionals will often utilize both informal and standardized sources of information in arriving at a psychiatric diagnosis. On the other hand, standardized psychological assessments may entail the exercise of more or less clinical judgment. An inference that a youth with a score of 135 on the Wechsler Intelligence Scale for Children-III (Wechsler, 1991) is significantly above average in cognitive ability relative to a standardization group requires relatively little clinical judgment. The use of the score to derive a specific diagnosis or to project future performance may, however, require a measure of clinical judgment. Similarly, combining scores from multiple standardized measures usually depends on subjective procedures, although in some cases we have available statistical or actuarial procedures for this purpose. These issues are explored in more detail in chapter 5.

The final step in the assessment process is the translation of the judgment into a decision. Thus, the youth judged at high risk for delinquent behavior is placed in a residential setting; the person judged as high in math aptitude is placed in a special enriched class; or the severely depressed youth is provided a psychotherapeutic treatment. This phase, too, can exhibit more or less structure. In most cases the actual decision is made by the clinician or counselor on the basis of the diagnosis. However, as we will see, there are now some efforts to develop standardized statistical or logical formulas for directly translating diagnoses into decisions. An example is use of an empirically derived formula to derive a risk classification for a youthful offender and to link that directly with the level of custody to assign him or her.

THE IMPORTANCE OF STANDARDIZED PSYCHOLOGICAL ASSESSMENTS

The first assumption stated at the beginning of the chapter was that the quality of decisions about clients depends very directly on the validity of the assessments on which the decisions are based. There is ample evidence from the clinical literature that many inappropriate decisions have been made on the basis of invalid assessments of clients’ characteristics and situations. For example, countless adolescents have been misdiagnosed and inappropriately placed in opportunity classes for the developmentally delayed, secure custody facilities for youthful offenders, or treatment programs. Conversely, many others have been deprived of needed services through inadequate assessments.

The second assumption was that standardized psychological instruments and procedures are more likely to produce valid and useful information than the informal and unstructured clinical procedures so often used in applied settings. The arguments in favor of this assumption are developed through this book, but an overview of the major points is appropriate here.

The third assumption was that assessment instruments should be appropriate for the individual. As shown in later chapters, there is a growing body of increasingly sophisticated standardized assessment tools and procedures for adolescents. These apply to the whole range of aptitude, personality, attitudinal, and environmental attributes of interest in applied assessment situations.

There are, to be sure, limits on the reliability and validity of these instruments, but significant advances are easily documented. In clinical assessments, on the other hand, there is generally no psychometric information available. Further, as we see in chapter 4, where direct comparisons have been made between clinical and standardized assessment procedures, the latter have nearly always proven superior.

The issues of consistency and control of bias arise in clinical assessments. Industrial psychologists have long argued in favor of the use of standardized assessment and selection procedures in job hiring situations. These procedures help ensure that applicants are treated consistently and that individual biases and prejudices do not confound the selection process. The same point could be made with respect to many of the decision situations involving adolescents, whether they involve streaming into academic programs, placement in special classes, or referrals to residential or custodial settings.

Finally, operational definitions of standardized psychological assessments are available. There is sometimes ambiguity and controversy over the constructs assessed by tests and other measures, but at least the bases for the assessment are explicit because they are represented in the content of the measure. In clinical judgments, there is generally no such information. This is an important consideration from the point of view of understanding and justifying our judgments and decisions.

The emphasis thus far has been on the benefits of improved assessment procedures for the individual client. It should also be clear, though, that the use of standardized assessments and structured diagnostic procedures can also provide positive gains in the management of system resources. Schools, hospitals, juvenile justice systems, and community-based services are all concerned with the optimal use of resources. I try to show later that this is best achieved where service delivery decisions are based on accurate assessments of the needs and circumstances of the client.

Various cautions regarding the use of standardized psychological assessments are given in the following chapters, but several caveats need to be noted at the beginning.

First, we must acknowledge that there are areas in which effective standardized assessment instruments have not been developed; here we are forced to use more subjective methods of assessment. One example is the assessment of risk for suicide. Although efforts to provide some screening tools have been made, clinical judgments still form the main bases for these risk assessments.

Second, we must emphasize that the application of psychological assessments usually requires special training and experience. The level of expertise required varies rather widely, but there are an unfortunate number of misdiagnoses arising from the use of the measures by unqualified individuals. The various ethical guidelines that have been developed regarding psychological assessment are reviewed in chapter 5.

Third, we must point out the danger that the use of standardized psychological assessments and structured diagnostic procedures might limit the opportunity for the exercise of professional discretion. There is a serious issue involved here. Although I have argued that standardized assessment tools are preferable to the more clinical procedures, they are still imperfect instruments, and ultimate decisions about clients must rest with the responsible educator, clinician, or service provider. I develop this point further in a later chapter in my discussion of what is referred to as the professional override principle.

TYPES OF PSYCHOLOGICAL INSTRUMENTS AND PROCEDURES

There has long been a tendency to equate psychological assessments with psychological tests. In fact, most of the standard textbooks on assessment include the term test prominently (or exclusively) in their title. To some extent this practice reflects reality: There is, in fact, a heavy dependence on tests and self-report inventories in applied settings. This is illustrated in Table 1.1, which is based on a usage survey of clinical psychologists who work with adolescents. It can be seen that standardized tests (e.g., Wechsler Intelligence Scales, Minnesota Multiphasic Personality Inventory, Beck Depression Inventory) and projective tests (e.g., Rorschach Inkblot Test, Kinetic Family Drawing) are heavily weighted in the listing.

Although the frequency listing in Table 1.1 is undoubtedly accurate, there are two cautions to be observed in interpreting those data. First, the survey was conducted with clinical psychologists, and, hence, it does not include other types of practitioners who work with adolescents. It is likely that these other practitioners—school psychologists, vocational counselors, and mental health professionals who are not psychologists functioning in mental health and juvenile justice settings—might employ oth...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Preface
• 1: Introduction
• I: An Introduction to Contemporary Research and Theory on Adolescence
• II: An Introduction to Psychological Assessment
• III: Assessment Instruments
• Appendix
• References