CPI

[LadyHalcyon]

What are your thoughts on using CPI when FSIQ and GAI are not interpretable? I am tempted to include it in the report but then state that the best way to interpret the data may be to focus on the individual indices, as I am hesitant to use a CPI for an overall measure of intelligence. In fact, I was always told verbal is the best overall predictor of intelligence. For references, here are the scores:
VCI=98
PRI=73
WMI=71
PSI=79

All the indices are interpretable and hang together.

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[Justanothergrad]

Yes, verbal loads the highest onto measures of G/FSIQ. I select what to include/how to include it based on how it best accomplishes my goal of conveying what information is revealed through testing (I.e., does a CPI add to the narrative or confuse it for readers based on the scatter for FSIQ? Can the information being conveyed another way more effectively? etc).

However, what I do seems irrelevant to what you should do. What is your supervisor directing you to do? You should do that.

 

[bcliff]

Do you have data from a word reading task (e.g., WRAT)? I, personally, would most likely (if working with an adult) interpret that, followed by VCI for a rough estimate of premorbid verbal abilities (watch education as a potential confound). I would also emphasize the discrepancies between VCI and all other indices. I second what JAG said about trusting your supervisor before me. CPI would likely also fall in the borderline range, so I don't think it tells you anything more than what is garnered by interpretation of WMI and PSI independently. I would not interpret CPI as a proxy for FSIQ or premorbid abilities.

 

[LadyHalcyon]

Do you have data from a word reading task (e.g., WRAT)? I, personally, would most likely (if working with an adult) interpret that, followed by VCI for a rough estimate of premorbid verbal abilities (watch education as a potential confound). I would also emphasize the discrepancies between VCI and all other indices. I second what JAG said about trusting your supervisor before me. CPI would likely also fall in the borderline range, so I don't think it tells you anything more than what is garnered by interpretation of WMI and PSI independently. I would not interpret CPI as a proxy for FSIQ or premorbid abilities.

I also gave him the WJ IV (and a bunch of other tests). He struggled a lot on word attack. I think he can recognize sight words and figure out the meaning through contextual clues, but his phonological processing is poor. My supervisor was unaware of what a CPI was.....

 

[LadyHalcyon]

Yes, verbal loads the highest onto measures of G/FSIQ. I select what to include/how to include it based on how it best accomplishes my goal of conveying what information is revealed through testing (I.e., does a CPI add to the narrative or confuse it for readers based on the scatter for FSIQ? Can the information being conveyed another way more effectively? etc).

However, what I do seems irrelevant to what you should do. What is your supervisor directing you to do? You should do that.

Thanks. That is what I was thinking. But to answer your question I do think the CPI will add to the narrative I just have to explain why his VCI was so much higher.

 

[Justanothergrad]

Thanks. That is what I was thinking. But to answer your question I do think the CPI will add to the narrative I just have to explain why his VCI was so much higher.

And more importantly, what does your supervisor think you should do? Regardless of if he knows what the CPI is, your report should reflect what he/she wants based on her/his knowledge and interpretation

 

[LadyHalcyon]

And more importantly, what does your supervisor think you should do? Regardless of if he knows what the CPI is, your report should reflect what he/she wants based on her/his knowledge and interpretation

Yes, in an ideal world that is how it should work. As mentioned previously, my supervisor was not aware the CPI even existed. I just personally am hesitant to include it as a substitute for FSIQ for numerous reasons. That being said, I was leaning toward including it but mentioning it is not the best indicator of his overall cognitive functioning BUT given the fact his FSIQ and GAI are not interpretable it at least does give some estimate of his cognitive processing abilities.

 

[Justanothergrad]

Yes, in an ideal world that is how it should work. As mentioned previously, my supervisor was not aware the CPI even existed. I just personally am hesitant to include it as a substitute for FSIQ for numerous reasons. That being said, I was leaning toward including it but mentioning it is not the best indicator of his overall cognitive functioning BUT given the fact his FSIQ and GAI are not interpretable it at least does give some estimate of his cognitive processing abilities.

No, not an ideal world- the entire training world. You should do write a report your supervisor doesn't want or doesn't understand because they are liable legally for what you do. They are your supervisor, period. There may be additional dynamics and issues to consider (you are asking for supervision in an online forum afterall), but writing a report. These issues need to be addressed as well if there are competency concerns, but this does not excuse you from being supervised.

 

[LadyHalcyon]

No, not an ideal world- the entire training world. You should do write a report your supervisor doesn't want or doesn't understand because they are liable legally for what you do. They are your supervisor, period. There may be additional dynamics and issues to consider (you are asking for supervision in an online forum afterall), but writing a report. These issues need to be addressed as well if there are competency concerns, but this does not excuse you from being supervised.

This is one small component of an integrated report. Ultimately my supervisor has the final say and that's all fine and dandy. I personally was interested in other people's opinion of the CPI as a substitute for fsiq and/or gai. But I heard you the first 3 times about the supervision aspect. Thanks.

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[Justanothergrad]

I like when people asking for supervision online get snappy. It's cute.

 

[LadyHalcyon]

I like when people asking for supervision online get snappy. It's cute.

Thank you so much for your help. Greatly appreciated

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[psych.meout]

Thank you so much for your help. Greatly appreciated

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Methinks the supervision issues aren't so unidirectional.

 

[LadyHalcyon]

Methinks the supervision issues aren't so unidirectional.

Thank you. I shall reflect further upon this.

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[LadyHalcyon]

It's interesting because I browse other boards on SDN and it seems the psychology board is the most condescending and patronizing. I find this hilarious considering our training emphasizes an empathic, non-judgmental, and respectful approach. Perhaps I should have posed the question slightly different by making it more broad, but what the hell is the board for if this isn't an appropriate question?

I think maybe my narcisstic and/or masochistic tendencies keep bringing me back here.



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[psych.meout]

It's interesting because I browse other boards on SDN and it seems the psychology board is the most condescending and patronizing. I find this hilarious considering our training emphasizes an empathic, non-judgmental, and respectful approach. Perhaps I should have posed the question slightly different by making it more broad, but what the hell is the board for if this isn't an appropriate question?

I think maybe my narcisstic and/or masochistic tendencies keep bringing me back here.



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You need to look past tone and see the wisdom being offered by people like Justanothergrad even if you don't like the way things are said. Being derogatory, snippy, and presumptuous about and towards your supervisor is a great way to get a less-than-stellar recommendation letter come internship apps. Furthermore, remember that supervisors are doing you an incredible favor. Training and supervision severely cut into their billing.

 

[LadyHalcyon]

You need to look past tone and see the wisdom being offered by people like Justanothergrad even if you don't like the way things are said. Being derogatory, snippy, and presumptuous about and towards your supervisor is a great way to get a less-than-stellar recommendation letter come internship apps. Furthermore, remember that supervisors are doing you an incredible favor. Training and supervision severely cut into their billing.

Now this is actually useful feedback and I do see your point. I feel like it was automatically assumed I was going behind my supervisors back when in fact he told me to interpret it as I see fit and basically gave me creative license so to speak. I will provide him with my interpretation of the data and we shall go from there. I think he trusts my clinical ability at this point and wants to see what I'm going to do with it first.

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[Harry3990]

Do you have data from a word reading task (e.g., WRAT)? I, personally, would most likely (if working with an adult) interpret that, followed by VCI for a rough estimate of premorbid verbal abilities (watch education as a potential confound). I would also emphasize the discrepancies between VCI and all other indices. I second what JAG said about trusting your supervisor before me. CPI would likely also fall in the borderline range, so I don't think it tells you anything more than what is garnered by interpretation of WMI and PSI independently. I would not interpret CPI as a proxy for FSIQ or premorbid abilities.

FWIW, I tend to agree with briarcliff that the CPI doesn't seem to add a whole lot of information. Like you leaned towards initially, I would emphasize the discrepancies and just look at each index individually, potentially looking for explanations in other sources of data for why the large discrepancy might be there if that is helpful contextually.

I would also say try to not take people giving you the "listen to your supervisor" caveat so personally. I agree that it is annoying, but I find it more helpful to just tune it out mostly (because "duh").

 

[WisNeuro]

It's interesting because I browse other boards on SDN and it seems the psychology board is the most condescending and patronizing. I find this hilarious considering our training emphasizes an empathic, non-judgmental, and respectful approach. Perhaps I should have posed the question slightly different by making it more broad, but what the hell is the board for if this isn't an appropriate question?

You definitely have not been to many other forums on DSN, then. This is by far, one of the tamer boards. Anyway, do not use CPI as a FSIQ proxy, it's essentially composed of the subtests that have historically held the lowest g-loadings. I wouldn't spend too much time belaboring a single measure of FSIQ regardless, it's generally meaningless when it comes down to the individual level. It really only has useful properties at the group level in large studies. Also, NO ONE uses CPI. I have literally written probably more than a thousand reports by this time, and read at least as many more. Not once has that been reported, and I am not surprised why. It's much more useful as a research entity than a clinical one. So, I wouldn't be too worried about your supervisor knowing what it is as long as their other clinical faculties are kosher.

That being said, focus on the patterns of testing and how it actually relates to the individuals day to day functioning. Don't get too hung up on clinically useless things.

 

[AbnormalPsych]

Also, NO ONE uses CPI.

Can confirm.

That being said, focus on the patterns of testing and how it actually relates to the individuals day to day functioning. Don't get too hung up on clinically useless things.

1,000% yes.

 

[Therapist4Chnge]

WisNeuro nailed it. The clinical relevance to the patient and the referral question are what matters.

 

[erg923]

And, I was just about to feel dumb for not knowing that the CPI was, although I could vaguely recall hearing about/learning about it at one point.

I don't think anyone in the real world breaks down the WAIS like they make you do it in training. At least, I've never seen it??? Its takes alot of time, has minimal impact in overall treatment planning, and you aren't getting paid much to do it. I'm not sure I would do it, or see the ROI in doing it, unless it was a psychoed eval or something similar.

This may be legitimate psychometrically, but let face it folks, most people don't read this part of your report. And no one understand it but you anyway.