5.5 Test Selection, Administration, Scoring, and Interpretation

Choosing and Using Tests Responsibly

Test selection begins after the referral question is clear. A psychologist should ask what decision must be made, what construct must be measured, how much confidence is needed, and what harms could follow from an incorrect conclusion. The instrument should match the question, the examinee, the setting, and the intended use.

No test is valid for every purpose. An intelligence test may support evaluation of cognitive abilities, but it does not by itself diagnose a learning disorder, predict violence, determine parenting capacity, or explain cultural adaptation. A symptom inventory may estimate severity, but it does not replace clinical interview, functional assessment, or differential diagnosis.

Competent test selection considers language, reading level, sensory or motor disability, age, education, cultural background, medical status, fatigue, and access needs. If a test lacks appropriate norms or translation evidence, the psychologist should not pretend the score has the same meaning. Options include selecting a better instrument, using an interpreter carefully, consulting, adding qualitative data, or limiting conclusions.

Standardized administration protects interpretation. Instructions, timing, materials, prompts, scoring rules, and testing environment should follow the manual unless there is a justified accommodation or modification. A quiet room, appropriate breaks, assistive devices, and disability accommodations may increase fairness, but changes that alter the construct measured must be documented and interpreted cautiously.

Validity indicators deserve special attention. Some instruments include scales for inconsistent responding, unusual symptom endorsement, defensiveness, or exaggerated distress. These indicators are not moral judgments. They are data about response style, comprehension, fatigue, emotional state, motivation, or context. The psychologist should interpret them with behavioral observations and collateral information.

Behavior during testing can change interpretation. Slow pace, impulsive responding, frequent questions, pain behavior, frustration tolerance, motor difficulty, language confusion, sleepiness, or unusual interpersonal behavior may explain scores or suggest additional hypotheses. Observations should be specific. Vague statements such as seemed unmotivated are weaker than descriptions of behavior and its possible effect.

Scoring errors are preventable but consequential. EPPP candidates should know that computerized scoring does not remove responsibility. The psychologist remains accountable for checking identifying information, norms, age calculations, missing items, protocol validity, unusual score patterns, and whether automated narrative statements are appropriate for the case.

Interpretation is integrative. A strong assessment report does not simply list test scores. It explains how the scores fit with the interview, mental status, history, records, collateral reports, functional impairment, and differential diagnosis. When sources conflict, the report should discuss the conflict rather than hide it.

Use this interpretation sequence:

1. Begin with referral question and data quality.
2. State major findings in plain clinical language.
3. Link scores to observed behavior and history.
4. Identify converging and conflicting evidence.
5. Discuss limitations, alternative explanations, and confidence.
6. Translate findings into recommendations that match the referral purpose.

The EPPP often favors a modest, evidence-based conclusion over an impressive but unsupported one. The best answer protects the examinee from misuse of tests while still giving the referral source useful, defensible information.