APNL NLPB response to proposed NB Bill 35 (02/06/2021)
May 10, 2021
The APNL and the NLPB have written a letter to The Hon Blaine Higgs, Premier of New Brunswick, to express concerns and opposition to the proposed Bill 35 (Section 11).
May 10, 2021
The Hon. Dominic Cardy
Minister of Education and Early Childhood Development
Government of New Brunswick
Place 2000, PO Box 6000
Fredericton, NB E3B 5H1
We are writing on behalf of the Association of Psychology Newfoundland and Labrador (APNL) and the Newfoundland and Labrador Psychology Board (NLPB) to express our concerns and opposition to the proposed Bill 35 (Section 11). Our goal, in writing this letter, is not to protect the self-interests of Psychologists, but rather to protect the learning, social and emotional needs of the students of your province. We fully endorse the essential need for early and timely access to assessment, when needed, to help address learning challenges in children. However, it is important to ensure that these children receive the appropriate assessments, delivered by suitably trained professionals, which can help lead to diagnoses (when needed), and guidance to the school staff as to how to best deliver evidence- based interventions.
We feel it may be important to clarify the different aspects involved in assessment, and the various individuals who may need to be involved. Classroom teachers are frequently the first professionals who may see some signs of learning struggles in their students. They then reach out to parents and various school team members to alert them of their concerns. Depending on the concerns, the child may then be seen by their family physician or pediatrician, a speech language pathologist, occupational therapist, special education teacher, guidance counsellor, additional members of the school support team, and/or an educational or clinical psychologist. Based on concerns expressed by any of these team members, additional more formal assessment may be required.
Psychometric assessment is a specialized skill which requires advanced graduate level training to understand the psychometric properties of tests, an understanding of a standardized administration and training in the strict administration protocols. Standardized administration is essential to ensure that the scores obtained on an assessment are accurate, and not a reflection of administrator error or bias. These skills are typically taught as part of a Master’s level coursework, and cannot be simply learned in a weekend or week-long training course. Test administration is often conducted by a Psychometrist under the supervision of a Registered Psychologist. Psychologists are typically involved in selecting the appropriate measures to be used, based on the referral question or concerns. Psychometrists are highly trained in test administration and scoring and are highly proficient and efficient in administering a wide variety of assessment tools.
Psychological tests have various levels of restrictions on them, primarily based on the interpretation skills required and potential diagnostic implications of the results, or repercussions if results are incorrectly interpreted. These are frequently referred to as “Level C” tests. These tests include measures of intelligence, memory, executive functioning, adaptive functioning, and personality. Pearson Canada, which sells the WISC-5, a measure of childhood intelligence lists the following qualifications in order to purchase these tests:
Tests with a C qualification require a high level of expertise in test interpretation, and can be purchased by individuals with:
A doctorate degree in psychology, education, or closely related field with formal training in the ethical administration, scoring and interpretation of clinical assessments related to the intended use of the assessment,
Licensure or certification by a provincial College of Psychology to practice in your province in a field related to the purchase,
Certification by or full membership in a professional organization such as College of Psychology, the Canadian Psychological Association (CPA), the Canadian Register of Health Service Providers in Psychology (CRHSPP), the Canadian Association of School Psychologists (CASP) or other North American organizations such as the American Psychological Association (APA) that requires training and experience in the relevant area of assessment.
Following test administration is the far more complex issue of test interpretation and differential diagnosis. In the case of school-age children, these skills require advanced training and knowledge in child development, child psychopathology, learning and behavioural disorders, psychometrics, advanced statistics, test selection, as well as a thorough understanding of test interpretation. Psychological assessment interpretation is far more complex than score X = diagnosis Y and requires a thorough understanding of differential diagnosis.
As an example, a child in Grade 1 may be struggling with their learning. Potential explanations could include a learning disorder, a language disorder, a delay in phonics skills due to lack of exposure needed for skills development, an intellectual disability, ADHD, ASD, OCD, fine motor delays, anxiety, depression, trauma,, family circumstances, lack of sleep, or any number of additional factors. Assessment of this child by someone with limited training and understanding in assessment, only using a limited number of tools risks either missing a potential diagnosis, or making an incorrect diagnosis. These errors can have lifelong implications on the child’s educational, social, and emotional development.
Of course not every child who is struggling requires an early comprehensive assessment. Early intervention programs (e.g. targeting phonics skills), extra supports from teachers, collaboration between home and school to address areas of weakness may be able to address a student’s early struggles. However, in many cases, an early, comprehensive assessment can help prevent additional emotional and learning needs. For example, a child with undiagnosed ADHD risks developing additional learning issues due to partial comprehension of tasks, particularly early math facts which fail to become automatized and continue to impact on subsequent learning in that area. A child with an undiagnosed specific learning disorder becomes discouraged, disinterested in learning, and develops poor self-esteem and more significant mental health issues.
We understand that the CPNB has proposed a number of strategies to assist with the recruitment and retention of Psychologists within the New Brunswick school system. We support them fully in these initiatives as we all agree that the goal is early access to high quality assessment and supports when they are needed. One possible solution would be to introduce the use of specially trained Master’s level specialist teachers, under the supervision of your Registered Psychologists, to become part of the student support team. Master’s trained Psychometrists could complete the testing, while supervision of the Psychologist, and test interpretation and diagnosis become the responsibility of the Psychologist. This would allow for more timely access using an appropriately qualified team.
This suggestion is similar to the model is use here in NL. Guidance Counsellors, who have completed the M.Ed in Counselling Psychology receive two graduate courses in assessment, one in assessment foundations (ED6707) and one in the administration of the WISC-5 (ED6709). ED6709 is taught by a Registered Psychologist, practice administrations are reviewed by the Psychologist to ensure proper standardized administration, and students are told explicitly that they are being trained in test administration, NOT interpretation and diagnosis. Students are then required to complete a practicum placement where they complete assessments under supervision. Historically assessments completed by Guidance Counsellors indicated eligibility for school board exceptionality classifications, NOT diagnoses. Current practice has shifted somewhat and has created significant issues for many families – for example, an assessment completed by a Guidance Counsellor is not eligible for the Disability Tax Credit nor for student support services in post-secondary institutions across the country.
Psychology regulatory boards across Canada are primarily concerned with protection of the Public from the actions of Psychologists. If a Psychologist selects inappropriate testing measures, makes inaccurate conclusions while interpreting testing data, misses a diagnosis or misdiagnoses a child, the family have a source of recourse against the Psychologist (including potential disciplinary and/or legal action). Psychologists carry malpractice insurance and are required to participate in regular quality assurance activities. If an assessment is conducted by a non-licensed individual, there is no recourse available to a family, other than potential legal action against the employer (school board).
The children and families in New Brunswick deserve access to early, appropriate, skilled assessments that include Registered Psychologists as part of the multi disciplinary school support team. Rapid access to poor quality assessments by unqualified unlicensed individuals risks legal action again the Department of Education, and more significantly, risks the long-term learning and mental health of your students.
Dr. Janine Hubbard, Ph.D., R. Psych John Harnett, MA
President, APNL Registrar, NLPB
Cc: The Hon Blaine Higgs, Premier of New Brunswick
Roger Melanson, Leader of the Official Opposition
David Coon, MLA, Leader of the Green Party of New Brunswick
Kris Austin, MLA, Leader of the People’s Alliance of New Brunswick
Mandy McLean, Executive Director CPNB
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