WAIS-III and WAIS-IV ethics and critical thinking

[erg923]

---

Members don't see this ad.

In my Boston Process class we are training on the WAIS-IV. This is fine. However, in class we got into discussion about the APA ethics code and tests that are being churned outr by Pearson, PAR, and the like. Someone made a comment about WAIS-III now being "outdated" or obsolete. I was surprised at the lack of objection to this in the class and was sitting in the back going "What the hell? Wait, lets think about this for a second please!"

So, Im curious:
When do tests violate 9.08? When might we ever say an instrument or its norms are out of date? For example, can we still use the MMPI-2 and MMPI-2 codetype interpetations now that we have MMPI-2 RF and MMPI-2 RC? At what point did the PIAT or the original WRAT pass the date of obsolence? One month, one year, two years after its update came? When does a test become too old to use "ethically" anymore? I mean Reitan still advises using the original WAIS with the HRNB, but I dont see anyone filing board complaints against him. And most importantly, how does one go about demonstrating scientifically (or emprically) that the test in question is indeed, "obsolete?"

Are we to just throw all the lit (co-normed tests, patterns, etc.) based on the WAIS-III out the window and say its now "obsolete." I mean how do we really know that the WAIS-IV is better than WAIS-III. Just because they (Pearson) say it is? Get real! Keep in mind these tests (WAIS) are developed at the discretion of Pearson, which stands to make a substantial penny from marketing the notion that the WAIS-III is now "obsolete." Was the new test development motivated by psychologists who expressed significant dissatisfication with existing versions of these tests. Or by corporate interest in having a new product to sell? (rehetorical question) So, in other words "when they build it, do we have to come?" If so, why exactly?

 

[erg923]

In case no one has noticed, the time betwen versions is shortening. It only been 12 years since WAIS-III came out. It was 26 years from WAIS to WAIS-R, and 16 years from then until WAIS-III. Hmm..interesting. I must have missed a centinal article on theory of intelligence in the past decade. And yes, I know the demographics of the US have changed somewhat since 1996, but even Pearson defends the integrity of the WAIS-III norms as recently as 2008. So I'm not understanding the rational for a new WAIS, besides money. This automatic assumption of "newer=better" demostrates a frightening lack of critical thinking amongst practioners. Am I alone here? It seems to me that it is we, the profession, that should be the one's to designate tests as no longer viable for use -- not marketing documents from a company whose financial livelihood is depended upon our spending our hard-earned dollars on their new products. And that designation should be absed upon science -- not merely the passage of time.

Any thoughts, comments? Anyone?

 

[Ollie123]

Haven't examined it carefully yet (though I will be over the next 2 months!), though I agree we need to be cautious about assuming newer = better. I think they dropped some of the less reliable subscales, etc. I suspect it truly is better, but whether it is a substantial enough improvement to justify the cost is another matter.

As to the broader question of when a test is outdated, I don't think there's an answer. People get away with all kinds of crap far worse than properly administering the WAIS-III shortly after the new version comes out. I suspect the code of ethics is intentionally vague, and will probably be reserved for people who are using things that are wildly out of date.

 

[erg923]

Yes, they dropped some subtests and added some new ones that are indeed interesting (figure weights), yada yada yada. That great and all, but does it increase the validity of assessing "G".....? Fancy subtests in the new WAIS are only useful if they truely assess the construct they purport to measure (ie., "G"), and we (psychologists) dont even agree on what "G" is half the time!

I also dont consider WAIS-IV "better" because of all the other problems in creates in the assessment process. For example, the abbreviated Wechsler scale, the WASI, was normed and correlated with WAIS-III only and there is no WASI-II on the horizon? This means that if people declare WAIS-III "outdated" or "obsolete" you then have to conclude that the WASI is obsolete too since its norms for estimating FSIQ were derived from WAIS-III. Moreover, the WTAR (a very popular reading test for premorbid IQ estimate) is also derived from WASI-III norms. So, now, if I use WAIS-IV, I have no psychometrically valid premorbid IQ estimates since WTAR was based off WAIS-III and there is not yet a WTAR-II that's based off WAIS-IV. Seriously, I dont understand why Pearson did not consider these issues before developing and marketing a new WAIS!

 

[Ollie123]

Welp, like I said, I haven't looked into it at all at this point. Intelligence testing is more than a little outside my domain, and not something I'm likely to ever do after internship.

I'm going to be digging through the literature this next month though, since the time has come to learn it since its already been a problem with 1 client that I'm not trained in it. I can't answer the question about g - I haven't been following the IQ literature enough to know what advances have been made in our understanding of it over the past decade.

 

[erg923]

I'm going to be digging through the literature this next month though, since the time has come to learn it since its already been a problem with 1 client that I'm not trained in it.

Oh, juicy gossip, do tell... Just kidding.

 

[Ollie123]

Afraid you may be disappointed with the caliber of the juicy-gossip. Couldn't have done a proper eval on an ADHD case.

 

[FadedC]

I've been reluctant to comment on this because I'm still an early phd student with no field experience so I'm sure there are people who know more then me. But according to my ethics teacher, when a new test comes out you have one year to learn it and after that it might reasonably be viewed as an ethical violation to use the outdated test. This is just classroom learning, so I have no idea how it actually works in the real world.

 

[erg923]

Dont be shy about commenting. However, I am well aware of what the ethics code (and professors) tell us. I don't want to get caught up in "group think" and consensus mindset though. What im interested in is the scientific rational and thought process behind this one year marker that you mention. Especially considering that its not "the profession" that is churning out the new WAIS, its a company that needs to make money and profit, jsut as all businesses do. Pearson has a very large monoply on this business and the vaguness of our ethics code is an absolute marketing dream for them, think about it! We are at their whim because the ethics code is written this way. What's to stop Pearson from developing WAIS-V with some new bells and whistles in 5 years? Since its "unethical" not use the latest version, and we have "one year" to get with the times, out come the pocketbooks again. This makes us look more liike sheep than behavioral scientists, IMHO.

 

[nononora]

But according to my ethics teacher, when a new test comes out you have one year to learn it and after that it might reasonably be viewed as an ethical violation to use the outdated test. This is just classroom learning, so I have no idea how it actually works in the real world.

In the real world, sadly, there are apparently practitioners and organizations still using the WAIS-R because they have a boatload of protocols and throwing them away would be "financially irresponsible". I wouldn't be surprised if many practitioners switch only after they've used up all their stock, and I don't blame them with the ridiculous prices Pearson charges. Would anyone throw away a package of 25 response books and record forms that cost them $193? What about a $1000 WAIS-III kit?

An exchange program would be nice no? Perhaps mail in your WAIS-III kit + $200 for an upgrade to a WAIS-IV kit. Hey, one can dream.

 

[GiantSteps]

The New York OMR/DD (Office of Mental ******ation/ Developmental Disabilities) put out a memo in October of 2008 stating that effective September 1, 2009, they will no longer accept the WAIS-III and expect the WAIS-IV to be given or another test such at the Stanford-Binet 4. If the OMR/DD is making this policy then Medicaid will most likely follow and not pay for psychologicals done with an older test. So in the end, even if the old test is better or if the new test is flawed, no one is going to give a test for which they do not get paid.

 

[erg923]

I have never known medicaid to ask me for a test list when I do an eval. Other issurance companies have though. Nevertheless, I anticipated JN's comment about the build up of lit on the WAIS-III (especially pattern analysis in neuro pops) by hundreds and hundreds of researchers and practioners. Now, with WAIS-IV we have norms studies from Pearson ONLY. And of course the fact that so many tests are co-normed with it, as I mentioned before, and Pearson apparently didnt think ahead and invision this as a problem or inconvenince for practitioner, especially neuropsychologists. Unreal! My rational is that we have much more lit on the WAIS-III and will for sometime yet still. Until then, its is probably most ethical to keep using it, instead of WAIS-IV. Especially in diagnostic neuropsych evals. WAIS-IV can get "phased in" over the next 5-6 years of so as the literature poors in. This seems reasonable to me.

Still, I'm not totally convinced this new version was based out of any new insights into assessing "G". Comes off more as, "well, why not?" "Lets give it a try." The test is not shorter (well maybe by like 10 minutes) than the prior version either, so they can't make administration issues an defensible argument either.

 

[goose 101]

I am sure some one will quote the flynn effect as being a reason to update the test's. But then, if that was the reason, why not just update the norms? Then send us the new information about the updated norms for a small fee (note small fee).

I have noticed (actually it was brought to my attention) that the WAIS IV seems to be giving lower FS IQ scores compared to the WAIS III. The individual that pointed this out has plenty of experience with the WAIS III so i started to pay attention more. I too have noticed that the WAIS IV appear's to be giving lower then expected scores. Any thoughts?

This has caused me to wonder "how do they come up with the FS IQ score". Please dont respond and tell me that is a combination......no kidding! What i wonder is, how can a person with their VCI, PRI, WMI and PSI scores all being in the 50's have an FS IQ score in the 40's?! Anyone know how the FS IQ score is created? I cant seem to find any information on it. Its a little concerning to me that i have to take the FS IQ score on face value.

 

[Quynh2007]

Stanford-Binet 4

They are still accepting the SB4?

 

[Therapist4Chnge]

We have a WAIS-IV in our testing library, though it hasn't really been used much, I suspect because of the limited norms. I'm just starting my neuro rotation, so I'm sure I'll hear more about it going forward, but at first glance I'm not quite sure how the changes will effect interpretation, etc.

*edit*

whoops. fixed it.

 

[ClinicalTrainee]

I am sure some one will quote the flynn effect as being a reason to update the test's. But then, if that was the reason, why not just update the norms? Then send us the new information about the updated norms for a small fee (note small fee).

I have noticed (actually it was brought to my attention) that the WAIS IV seems to be giving lower FS IQ scores compared to the WAIS III. The individual that pointed this out has plenty of experience with the WAIS III so i started to pay attention more. I too have noticed that the WAIS IV appear's to be giving lower then expected scores. Any thoughts?

This has caused me to wonder "how do they come up with the FS IQ score". Please dont respond and tell me that is a combination......no kidding! What i wonder is, how can a person with their VCI, PRI, WMI and PSI scores all being in the 50's have an FS IQ score in the 40's?! Anyone know how the FS IQ score is created? I cant seem to find any information on it. Its a little concerning to me that i have to take the FS IQ score on face value.

Yes, the new version of the test is always going to have lower FS scores than the previous version. It brings up an interesting issue regarding MR or giftedness evals.....the former (seeking accommodations) would be better off taking the new test, whereas the latter (seeking, say, admittance to a gifted program or Mensa membership) would be better off taking the old version.

The answer to 'why' the FS score is lower from previous versions is tricky, I think. I mean, the simple answer is because of norming, but I'm sure there are other reasons too (including administration, doesn't it seem possible that people who are better at giving/scoring the test will end up with patients who have higher scores over time?).

As for the why FS IQ are higher, you can hand calculate the FS IQ (the manual should explain how to do this), so try it out and see. My basic understanding is that the FS comes from all the core subtests, and isn't just a combination of the four index scores (also, the index scores may include supplementary subtests, whereas the FS only includes the 'core' 10). Also keep in mind that being consistent across all index domains isn't necessarily the norm. Oh yes, and are you talking about *percentiles* in the 40s/50s as opposed to scores?

 

[goose 101]

The answer to 'why' the FS score is lower from previous versions is tricky, I think. I mean, the simple answer is because of norming, but I'm sure there are other reasons too (including administration, doesn't it seem possible that people who are better at giving/scoring the test will end up with patients who have higher scores over time?).

As for the why FS IQ are higher, you can hand calculate the FS IQ (the manual should explain how to do this), so try it out and see. My basic understanding is that the FS comes from all the core subtests, and isn't just a combination of the four index scores (also, the index scores may include supplementary subtests, whereas the FS only includes the 'core' 10). Also keep in mind that being consistent across all index domains isn't necessarily the norm. Oh yes, and are you talking about *percentiles* in the 40s/50s as opposed to scores?[/QUOTE]

Obviously norming plays a part in. I have no idea where you got this notion that people that are good administrators end up with individuals with higher IQ's. Seriously, you need to explain yourself on that. Or spend more time thinking about it.

Secondly, could you quote for me where it says it in the WAIS IV manual on how to calculate by hand the FS IQ score. Page number and what manual you got that out of would be most helpful (you may find after further looking that it is not in the manual [i dont mind you proving me wrong on this either])

 

[aagman01]

FYI...the fifth version of the SB has been for a few years.

Besides that, I would question the validity of using any supposed cognitive tests. Unless you are working with white middle class clients, they are basically worthless. That goes for the WISC IV onwards.

The New York OMR/DD (Office of Mental ******ation/ Developmental Disabilities) put out a memo in October of 2008 stating that effective September 1, 2009, they will no longer accept the WAIS-III and expect the WAIS-IV to be given or another test such at the Stanford-Binet 4. If the OMR/DD is making this policy then Medicaid will most likely follow and not pay for psychologicals done with an older test. So in the end, even if the old test is better or if the new test is flawed, no one is going to give a test for which they do not get paid.

 

[erg923]

Besides that, I would question the validity of using any supposed cognitive tests. Unless you are working with white middle class clients, they are basically worthless. That goes for the WISC IV onwards.

Please clarify and explain this statement. What research is this statment based on?

 

[goose 101]

FYI...the fifth version of the SB has been for a few years.

Besides that, I would question the validity of using any supposed cognitive tests. Unless you are working with white middle class clients, they are basically worthless. That goes for the WISC IV onwards.

i would agree with this if they only normed the assessment on the white, middle class individuals, but this is not the case. What do you know that i dont?

 

[erg923]

Actually both WISC and WAIS-III were hailed for their norms, as they were good matches with the 1990 US census data.

And the comment about being "middle class" is somewhat a distortion of the issue, as Im sure we are all aware that IQ is socially constructed construct anyway. Therefore, we are not assessing only innate (ie., fluid) inteliigence (nor are we trying to) in formal IQ testing. By definition inteligence is composed of social intelligences as well (ie., vocabulary and info typically learned during formal education, and coprehension of social norms and ideas).

 

[Psiguy]

FYI...the fifth version of the SB has been for a few years.

Besides that, I would question the validity of using any supposed cognitive tests. Unless you are working with white middle class clients, they are basically worthless. That goes for the WISC IV onwards.

Would you please clarify what you were trying to say in this post? Also, how much assessment experience do you have?

 

[Therapist4Chnge]

I wanted to bump this again because I think it is important to talk about new/updated measures, particularly for one of the more common instruments 98% of us have to learn during our graduate training.

 

[erg923]

How bout some wais-iv reviews for those of you (us) using it. What are you finding, and do you think its worth the arm and a leg it costs. Npsychs.....would you invest in it for your PP? Ill start, but will post it later.

 

[Therapist4Chnge]

How bout some wais-iv reviews for those of you (us) using it. What are you finding, and do you thinik its worth the arm and a leg it costs. Npsychs.....would you invest in for your PP? Ill start, but will post it later.

I have concerns about possible limitations in regard to accurate norms for special populations (in my case the geriatric population). I know there are some great norms for the III, though I doubt they exist for the IV. I'm not sure how much this will effect me down the road, but I'd prefer to have a choice, instead of just using the basic norms.

As for buying it for PP use....I'll buy it instead of the WAIS-III because it will eventually become the standard, and I do NOT want to "waste" $1000+ on a WAIS-III.

 

[erg923]

I had a supervior who used to say that there was no justification for "WAIS"ting time on an 90 minute long IQ test in the context of a larger neuropsychological battery.......and I tend to agree.

"G" is "G" whether you use a 15 minute screening IQ or a 90 IQ test. The return on your 90 minutes investment shaves off about 6-7 IQ points on either side of the confidence interval vs using the WASI or something similar. Unless its an Atkins death penalty case, I see no reason to be so psychometrically bound in a clinical evaluation.

 

[Therapist4Chnge]

I had have a supervior who used to say, unless it was a death penalty case, there is no sense in WAISting time.

I'll use the short form or cherry pick a few sub-tests for a neuro assessment, but that is about it. We generally don't have a ton of time, so having someone go through the entire WAIS rarely seems a good use of time.

 

[erg923]

My problem with short forrms is this: Using compiled short forms such as 7-subtest forms or 11-subtest form is that they were never normed for that purpose. Kaufman talks about this in his article "The death of the short form" or some title like that in which he expressly argues against using compiled short forms based on extracted subtests.

What I do like is the WASI. The WASI was normed for that purpose. As I mentioned before, with exception of forensic cases, I find that the WASI is morew than adaquate for your average "name that tune" type npsych eval. I have a difficult time understanding the argumentrs of others who insist on using full WAIS for every eval. In adult npsych, the IQ in is used as benchmark (except in MR evals) and thats about all. I dont need try to derive brain dysfucntion from it, that what all the other tests I give are for (although Block Design is sensitive to brain dysfucntion, and guess what? its in the WASI)! The purpose of a WAIS, in my mind, is to get "G".....if I can get "G" reliably in 45 minutes instead of 90 minutes, I will take that any day.

 

[erg923]

Here is my review after using WAIS-IV for the past 4-5 months in my practicum. Not tons of experience (about 20 administrations), but here goes.

There is nothing wrong with it. My issue is one of the continued "neuropsychologicaliztion" of an instrument that was never really designed for that. I continue with my stance that "G" is "G" and thats all I really want to pull from an IQ test. Some of the process stuff from the WAIS-III was not backed up by evidence, and I think one risked making "moutains out of mole hills" if you put to much neuropsych into its interpretation. However, WAIS-IV is supposed to have some good research to back up some of it process scores.

At face value, the test might even be measuring different constructs than the WAIS-III, IMHO. Subtests, items and stimuli have changed on the new versions. Object Assembly and Picture Arrangement have disappeared. Visual Puzzles is an entirely new subtest that looks like nothing presented on any of the prior Wechsler series. The instructions have dramatically changed to match the needs of the new test. There are separate forms for the aging population. Based on these changes, I think that is is very possible that we may be measuring "g" in a new way. I certainly would never used the orginal WTAR with the new WAIS, thats for sure.

I have heard that Shane Bush has a paper under review with TCN that discusses this problem from an ethical standpoint and argues that the publisher should have the burden of producing norms for a revised test that can readily be used with other neuropsychological tests when it is published. I think this is a good idea, to saythe least....

 

[NJNP]

Even though it has been several years since this thread started and over six months since anybody has posted, the question as to when a test is considered out-dated has not been answered.
In our practice, we routinely wait six months before purchasing the new version of a major test (WAIS, WMS, etc.), as we have in the past seen problems with the first revisions of the new tests (WIAT, NEPSY, etc.).

In my informal discussion with other neuropsychologists, I have always been told that this is reasonable, but does anybody know of any "official" guideline or published paper addressing this issue?

 

[Therapist4Chnge]

In my informal discussion with other neuropsychologists, I have always been told that this is reasonable, but does anybody know of any "official" guideline or published paper addressing this issue?

I am pretty sure this came up once on a listserv I frequent, but I can't recall if there was a set timeframe. I checked the APA Ethics Code (2002), and Section 9: Assessment did not specify a timeframe.

Dr. Ken Pope has a great website that covers a lot of ethical issues, though I poked around and didn't see anything specific about updating out-of-date assessments. I know that disposal of out-of-date assessment materials must include shredding, as to not compromise the validity of the assessment if it was found in the public domain.

Personally I have heard 6 months to 12 months, though more practically it seems that people make the change when it is required by a hospital/insurance company for reimbursement.

I am still not a fan of the WAIS-IV, but I'll be buying a kit because that is what will be expected.

 

[erg923]

Even though it has been several years since this thread started and over six months since anybody has posted, the question as to when a test is considered out-dated has not been answered.
In our practice, we routinely wait six months before purchasing the new version of a major test (WAIS, WMS, etc.), as we have in the past seen problems with the first revisions of the new tests (WIAT, NEPSY, etc.).

In my informal discussion with other neuropsychologists, I have always been told that this is reasonable, but does anybody know of any "official" guideline or published paper addressing this issue?

Well actually this thread was started only nine months ago.

But no, i don't think there is an official document guiding this other than the Ethics Code paragraph about not using outdated tests- which is poorly defined/worded and plays right into the hands of test publishers. David Loring had a good review out about these issues. A more scathing one from Bert Russell came out last month as well.

 

[AcronymAllergy]

The APA ethics code, as others have pointed out, states that psychologists are not to "base [assessment and intervention] decisions or recommendations on tests and measures that are obsolete and not useful for the current purpose," nor to use "data or test results that are outdated for the current purpose."

In the case of the WAIS-III/WMS-III, neither seems to be captured by the above-mentioned criteria. I would imagine the burden of proof should (ideally) rest with the test publishers to demonstrate that the new version actually significantly increases clinical utility.

 

[Therapist4Chnge]

There is nothing wrong with it. My issue is one of the continued "neuropsychologicaliztion" of an instrument that was never really designed for that. I continue with my stance that "G" is "G" and thats all I really want to pull from an IQ test. Some of the process stuff from the WAIS-III was not backed up by evidence, and I think one risked making "moutains out of mole hills" if you put to much neuropsych into its interpretation. However, WAIS-IV is supposed to have some good research to back up some of it process scores.

I have heard that Shane Bush has a paper under review with TCN that discusses this problem from an ethical standpoint and argues that the publisher should have the burden of producing norms for a revised test that can readily be used with other neuropsychological tests when it is published. I think this is a good idea, to saythe least....

I use sub-tests from the WAIS-III in the majority of my neuro assessments, though mostly to get a rough estimate of IQ and to see if anything really evident jumps out. I'd be curious to hear what people would pull from a WAIS-III in regard to neuro-specific assessment.

 

[erg923]

Letter-number sequencing and Digit Span always and Block Design fairly often. Coding often as well. I used to have a supervisor that stubbornly held to the myth that pic arrangment was a great measures of social context/judgment and made me give this in every assessment. grrrr Interesting? yes. vital information? no

With WAIS-IV geting down to about an hour or so, I think its a better alterntative than the 45 minutes WASI, so i give alot of WAIS-IVs now. I also know a supervior who has just switched over the RIAS (Cecil Reynold's test) due to his disgust with Pearson and a profession fixation on Wechlser's 80 year-old haphazard construct of intelligence.

 

[KillerDiller]

I used to have a supervisor that stubbornly held to the myth that pic arrangment was a great measures of social context/judgment and made me give this in every assessment. grrrr Interesting? yes. vital information? no

Yeah, I've heard of psychologists using Picture Completion as a projective measure, as if it's the TAT. This makes me cringe in a way that only this smilie can express.

 

[Therapist4Chnge]

Letter-number sequencing and Digit Span always and Block Design fairly often. Coding often as well. I used to have a supervisor that stubbornly held to the myth that pic arrangment was a great measures of social context/judgment and made me give this in every assessment. grrrr Interesting? yes. vital information? no

With WAIS-IV geting down to about an hour or so, I think its a better alterntative than the 45 minutes WASI, so i give alot of WAIS-IVs now. I also know a supervior who has just switched over the RIAS (Cecil Reynold's test) due to his disgust with Pearson and a profession fixation on Wechlser's 80 year-old haphazard construct of intelligence.

I find coding useful, though only in conjunction with a number of other measures. I never liked picture arrangement. The three questions from the Cognistat are a decent quick and dirty screen, but far from conclusive.

Yeah, I've heard of psychologists using Picture Completion as a projective measure, as if it's the TAT. This makes me cringe in a way that only this smilie can express.

Wow...just wow.

Just use the TAT! I'm not a huge fan of projective measures for Dx'ing, but they are interesting to see how someone perceives the world.

 

[AcronymAllergy]

I find coding useful, though only in conjunction with a number of other measures. I never liked picture arrangement. The three questions from the Cognistat are a decent quick and dirty screen, but far from conclusive.

If I'm going to give them, I like to have both coding and symbol search available because it allows one to tease apart (at least a bit) the effects of increased motor demands/involvement.

But yes, picture arrangement was the bane of my existence. Period.

Oh, and here's another vote for the WASI being pretty awesome. Although as erg mentioned, with the WAIS-IV supposedly (I haven't had a chance to administer one yet, so no first-hand knowledge) being shorter than its predecessor, I might start subbing it in.

 

[JockNerd]

I've been administering the WAIS-IV for a few months now as part of a battery for LD/Attention disorders, and I can't freakin stand visual puzzles. All the college kids who really just have some generalized or performance anxiety freak out when I give them the instructions.

 

[TenaciousGirl]

what do you do with the testing manuals and other testing paraphernalia once a test is deemed no longer ethical to give by a site you work for but may still be a test other sites give? Send it back to the publisher? Just keep them and let them collect dust? I own the manuals to the WAIS IV and WISC IV and this thread made me wonder what people do with the old ones. Choice and use of assessments are like adopting therapeutic perspective ... it all depends on the person. Unless of course you work for an agency that has a protocol set of assessments.

 

[TenaciousGirl]

Wow...just wow.

Just use the TAT! I'm not a huge fan of projective measures for Dx'ing, but they are interesting to see how someone perceives the world.

ditto. I've been taught that one test should never determine a diagnosis. Diagnosis should come from a plethora of things. It does make me curious, though, when I see a patient diagnosed with a disorder and they only have one assessment on file.

 

[Therapist4Chnge]

ditto. I've been taught that one test should never determine a diagnosis. Diagnosis should come from a plethora of things. It does make me curious, though, when I see a patient diagnosed with a disorder and they only have one assessment on file.

I usually don't trust most Dx's that come across my desk if there isn't formal testing. Clinicians are often lazy doing differential dx, particularly when a dx comes from 1 meeting.

 

[zoistaffy]

The WAIS-III is obsolete. I think it's unethical to charge someone for an "IQ assessment" if that is the assessment you used. If a psych just wanted a few subtests from it, or had another purpose to administer an IQ test than to know their IQ, then I don't know. I thought the WAIS-IV was a test of IQ which is important to rule out MR, explain ADHD, or predict academic success. Using an IQ test to assess for other things is inappropriate. At least that's what we were taught. We were taught to never use the WAIS-IV except as a whole and as a measure of IQ. The seperate subtests have no utility administered and interpreted outside the other subtests and without considering the domain as well.

For sites that don't have the WAIS-IV, then the standford-binet can be used as a current/reliable assessment of IQ. If one used the WAIS-III instead of WAIS-IV then that should definitely be addressed in the report, and I wouldn't charge a client for this test, since they will need to take a different test anyway for an accurate IQ score. But I'm sounding like my teacher. I'm just a first year clinical right now.

 

[erg923]

The WAIS-III is obsolete. I.

What does the term obsolete mean to you?

In your post, you seem to be arguing that the term "obsolete" is a synonym for "invalid", is this correct? If so, please explain to me why/how the psychometric properties of the WAIS-III were valid on July 31st 2008 and then suddenly became invalid August 1st 2008? As an example, I might argue that the Halstead's orginal version of the categories test is "obsolete" because we have no need for huge projectors with glass tubes (inconvienent, heavy, and takes up alot of space), glass slides (breakable). Further, we now have multiple other (easier to administer) measures for assssing this same construct. However, does this in anyway mean that the orginal categories test is "invalid" and unethical to adminster? I dont think so. Again, newer test does not necessarily mean an advancement in the understanding of the construct that is being measured by the test (eg., Intelligence). The automatic and unquestioning assumption of "newer=better" is not a very scientific way of looking at an complex issue/problem.

The fact is that many will continue to use the WAIS-III on a regular basis for the next several years at least because of the vast amount of lit and research supporting its factor structure. Pearson, INC (yes, its a for-profit company) publishing a new test in no way invalidates the research findings on the WAIS-III. However, as discussed before, I (and many practitioners) are using the WAIS-IV in most clinical evals. There is nothing really "wrong" with it. I like it in fact, and its a little bit quicker too. However, no one has yet even claimed, much less published research demonstrating that that WAIS-IV is somehow a "better" or more true/accurate Full scale IQ estimate than WAIS-III. If you can point me to this lit, id be happy to take a look at it.

I think it's unethical to charge someone for an "IQ assessment" if that is the assessment you used.

Um...well dont you think someone could argue that it is just as unethical to charge for the test that has less research conducted on its patterns in psychiatric and neurological populations (ie., WAIS-IV)?

Second, take a course on Boston Process Approach and/or the flexible battery and hypothesis testing approach to neuropsychological assessment. After this you will understand the rationale for administration of selected subtests based on their sensitivity to brain functioning (ie., coding, block design, etc.).

The seperate subtests have no utility administered and interpreted outside the other subtests and without considering the domain as well.

Yes, because coding, block design, letter -number sequencing, similarities, were all invented by David Wechsler in 1939 and were never used and never existed before being made into a whole battery....come on man.........Are you even vaugely familair with the history of psychometric assessment of cognitive functions?

 

[zoistaffy]

I think the WAIS-III can be considered obsolete due to 1) apa ethics 2) logic. Would you use a height/ weight chart from 1970 to assess normal now? No, because people change as a function of the environment and society to name a few reasons. The exact moment the cultural climate changes is impossible to know. Hopefully, you would never use the DSM-III to diagnose someone today. What do you think?

 

[erg923]

I think the WAIS-III can be considered obsolete due to 1) apa ethics 2) logic. Would you use a height/ weight chart from 1970 to assess normal now? No, because people change as a function of the environment and society to name a few reasons. The exact moment the cultural climate changes is impossible to know. Hopefully, you would never use the DSM-III to diagnose someone today. What do you think?

1.) Is reasoning on an authoritarian level and I dont know how to debate with people who reason in that manner.

In case you didn't read it, the question in the original post was: What constitutes "obsolete" (ie., what's the operational definition) as stated in that code. "Newer is better" is naive and lacks critical thought/investigation. "Because they say so" is naive and lacks critical thought/investigation. I thought we were scientists here? Isn't that what science does--question ideas and evaluate their logic based on evidence?

2.) Psychologists use empirical data and research to draw conclusions, not logic. Logic can be flawed an biased (unknowingly). Of course people change. But does that mean IQ changes significantly too? Well, not necessarily. The existence of the Flynn effect is debatable, unless you know of some research that I dont? By the way, Pearson doesn't appear to buy into the Flynn effect anyway, so this is likely not even one of Pearson arguments for the change. http://www.pearsonassessments.com/NR/rdonlyres/98BBF5D2-F0E8-4DF6-87E2-51D0CD6EE98C/0/WAISIII_TR.pdf And even if the Flynn effect is real, this means the average IQ is only appoximately 4 points higher (which is not clinically significant and within the SEM) than when the WAIS-III came out in 1997, no? If your are attempting to correct for IQ inflation in the normative population (as you propose we are), wouldnt new norms solve this? How does a new test help? The DSM analogy is not appropriate either because there actually was a shift in the criteria and conceptualization for some psych disorders from III to IV. There has been no change to the criteria for mental ******ation, average IQ, high average IQ etc. Yes, low average IQ looks the same and means the same thing today as it did in 1970.

Again, this is NOT to say that the WAIS-IV sucks. I generally like it. Although,I recommend that you have to get rid of this mentality that a newer version automatically makes the previous version obsolete (as other have pointed out, there is lot of research on diagnostic patterns, construct validity, criterion validity, and factor structure that doesn't suddenly become "wrong" when a newer version is released). That criteria doesn't meet any definition of the term obsolete that I have ever read. How bout you?

 

[PsychGraduate]

All I can say is I agree wholeheartedly with you. WAIS III is good to stick with scientifically speaking.

 

[PsyDetective]

http://www.apa.org/monitor/jun05/ethics.aspx

If you can articulate the appropriateness of your decision to administer the WAIS III versus the WAIS IV using sound scientific reasoning, based on your knowledge of the relevant literature and professional experience as a psychologist, then it is appropriate to do so. In fact, it may be in the individual's best interest to do so.

As a note, I was trained with and use the WAIS IV in forensic practice, but I recognize some unique and interesting aspects of the WAIS III and have thus taken it upon myself to learn the measure. In the end, we must be guided by empiricism, lest we fall prey to passion and unreasonable opinion. My .02 on the matter.

 

[paramour]

Sooo, to bump a reeeally old thread, is anyone still using the WAIS-III?

 

[AcronymAllergy]

I do know people who still use parts of it, depending on the setting. Pretty sure most have switched over to the IV at this point, though, if for no other reason than the insistence of students to have experience administering it.