Antonio E. PuenteUniversity of North Carolina Wilmington

LOST IN TRANSLATION:IS IT BACK TO FUTURE OR

FUTURE TO THE BACK

Acknowledgements

• UNCW Neuropsychology Research/Clinical Group• Universidad de Granada Neuropsychology•Moscow State University Neuropsychology• UCLA Cultural Neuropsychology Group• Alfredo Ardila & Monica Rosselli

• Any individual with Spanish-speaking background– Central and South America, Mexico, and

Spain

• 53 million individuals

• 11 million undocumented Hispanic immigrants

• Hispanics are the largest minority group– 17% of the US population

Hispanics in the U.S.

55%

8%

15%

16%

6%

Share of the Total Change of the U.S. Population between 2000

and 2012

HispanicWhiteBlackAsianOther

Source: Pew Research Center, 2009; U.S. Census Bureau, 2014

• Standards revised every 15 years over the last 50• Provide criteria for the development and evaluation of tests and testing

practices• Sponsored by:

– American Educational Research Association– National Council on Measurement in Education– American Psychological Association

(Note: Puente only clinician and only Spanish-speaker on the Committee for the Revision of the Standards of Educational and Psychological Tests)

Standards for Educational and Psychological Testing (2014)

Source: AERA, 1999

Defining Fairness

A test that is fair does not unduly advantage or disadvantage certain examinees because of individual characteristics that

are irrelevant to the construct being measured.” (AERA, et al., 2014)

Intelligence Testing: Diagnostic Standards• “Intellectual functioning is typically measured with individually

administered and psychometrically valid, comprehensive, culturally appropriate, psychometrically sound tests of intelligence.” DSM-5

• Accuracy of assessment requires that the assessment “[t]ake into account such factors as the individual’s culture, language, and any physical or other disabilities that may affect the validity of the assessment.” and “[u]se appropriate norms.” AAIDD (11th ed.)

Norms

• “Instruments must be normed for the individual’s sociocultural background and native language.” DSM-5 .

• Accuracy of assessment requires that those conducting the assessment “[u]se appropriate norms.” AAIDD (11th ed.) .

Re-Norming & Interpretation of Norms• Lizcano v. Texas, 2010 WL 1817772 (CCA) (unreported) (“Whether

or not ‘Spanish speakers’ as a group tend to score below ‘Caucasians’ on IQ tests, has little relevance for the proposition that, on the tests administered to him, the appellant's scores were somehow inaccurate due to his particular culture and influences.”).

• Maldonado v. Thaler, 625 F.3d 229 (5th Cir. 2010) (Assuming without deciding that Denkowski’s upward adjustment of IQ scores for a Spanish-speaking Mexican defendant based on his purported knowledge of Mexican cultural norms was improper)

1. Developed a list of available tests • 3,500 psychological tests in print in the U.S. • 555 (16%) are in Spanish.– 25 – 50 (4%) are used the most

2. Evaluation of the most commonly used tests by using the Standards• Only 6/25 tests meet all four criteria • Most did not meet the criteria for the Standards• Missing norms – Those with norms, may not be accurate

Puente, Ojeda & Zink (2015)

Phase 1: Results • Range of IQs and Indices –Mexican • Narrow Sum of Scale Scores (11 – 209 vs. ≤ 60 – ≥ 188)• Narrow IQ & Index Scores (~1 SD)

– Puerto Rico• Identical Sum of Scale Scores• Broader IQ and Index scores

– Spaniard• Identical Sum of Scale Scores

• Identical IQ and Index Scores except PSI (54 – 150 vs. 54 – 143)

– Comparison Sample: Perceptual Organization Index

English Mexican Puerto Rican SpaniardSum of Scale Scores 3 – 57 ≤ 16 – 113 3 – 57 3 – 57

Index Scores 50 – 150 69 – ≥ 294 44 – 158 50 – 150

Phase 1: Results • Average Confidence Interval Ranges:

Version VIQ PIQ FSIQ VCI POI WMI PSI

English 9.6 14 8 11.2 14 14 17.8

Mexican 26.2 48.8 37.4 41 20.4 50 8.4

Puerto Rican 9.6 12.4 8 11.2 14 15 19

Spaniard 10 12 16 8 8 8.4 8

Phase 2: Results Summary• Overestimation of IQ and Index Scores Variable Mean English Score

Total Point Overestimation

Mexican Puerto Rican Spaniard

Full Scale IQ 88.60 3.30 14.28 4.70

Verbal IQ 89.46 3.69 15.00 2.83

Performance IQ 89.40 7.20 10.89 (-0.21)

Verbal Comprehension Index 90.65 9.75 13.81 2.37

Perceptual Organization Index 92.23 6.23 10.54 (-1.98)

Working Memory Index 86.58 12.52 15.42 3.43

Processing Speed Index 88.15 13.10 7.27 3.50

Houston: Do We Have a Problem?

VI. Knowledge base.Clinical neuropsychologists possess the following knowledge. This core knowledge may be

acquired through multiple pathways, not limited to courses, and may come through other documentable didactic methods.

4. Foundations for the practice of clinical neuropsychologySpecialized neuropsychological assessment techniquesSpecialized neuropsychological intervention techniquesResearch design and analysis in neuropsychologyProfessional issues and ethics in neuropsychologyPractical implications of neuropsychological conditions

Source: Arial Narrow 8 pt.

Houston: We DO Have a Problem• Only comment in the Houston Guidelines:

XIII. Diversity in education and training.The specialty of clinical neuropsychology should attempt to actively involve (XIII. Diversity in education and training.The specialty of clinical neuropsychology should attempt to actively involve (enroll, recruit) individualsfrom diverse backgrounds at all levels of education and training in clinical neuropsychology. ) individualsfrom diverse backgrounds at all levels of education and training in clinical neuropsychology.

Are We Better Off Two Decades Later?• Total #/% of Hispanic neuropsychologists• Total #/% of board certified neuropsychologists• Total #/% of leaders • Total #/% in academic & training positions• Total #/% of empirical rather than “aspirational

articles

Time to Stop Talking & Start Doing

• Establishment & stability of HNS• NAN Translation position paper• Some viable translations•What is next?

Resources• American Psychological Association– Ethical Standards for Psychologists– Standards for Educational and Psychological Tests &

Assessments– Guidelines on Multicultural Education, Training, Research,

Practice, and Organizational Change for Psychologists• National Academy of Neuropsychology• Hispanic Neuropsychological Society• Available book chapters & articles– www.antonioepuente.com– www.alfredoardila.wordpress.com