Progress will come in the balancing of needs: Professional desires, consumer demand, and why we have to specialize.

Conoley, Powers, and Gutkin (2020) have provided an assessment of the progress and lack thereof of school psychology as a profession toward school reformation, especially as related to their various earlier calls for changes in training and practice. Conoley and Gutkin especially (and I have been colleagues of both) have called for decades for an emphasis on working with teachers, other adults in the school system, and the school system itself to alter the delivery of education. In some earlier work, they have characterized this as adult school psychology. In many ways this is a reconceptualization of earlier mental health consultation models of school psychology practice that were not widely adopted for reasons Conoley et al. (2020) explain. School psychology has a long history of wanting to be seen and to practice differently from in a primary role of test and place, and indeed I would characterize the primary organizations that represent the profession (the National Association of Psychologists and the American Psychological Association's Division of School Psychology) as being in many ways antagonistic toward psychological testing. Yet, it is what most school psychologists are in fact hired to do as their primary role, and training in psychological testing and assessment is one of the key skills that sets us apart and distinguishes us from others in the schools. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Evidence-based assessment of ADHD diagnosis in children and adolescents.

This study illustrates the accuracy and efficiency of using an evidence-based assessment (EBA) strategy for diagnosis of attention-deficit/hyperactivity disorder (ADHD) by integrating the scale scores obtained on BASC-3 teacher and parent rating scales. The examined process used empirical diagnostic likelihood ratios (DLRs) derived from a sample of children with ADHD (N = 339) matched on demographic characteristics from the normative sample. The results show that behavioral scales of executive functioning and functional communication provided incremental utility in ADHD diagnosis. With a revised probability of .80 or higher as the diagnostic criterion, teachers, and parents positively diagnosed 70% and 94% of the ADHD cases respectively. The EBA approach was efficient, with four scales on average used to reach the proposed posterior probability for final diagnosis. Finally, teachers and parents demonstrated a high agreement with respect to the diagnosis results and scales used for the diagnosis.

Two-factor structure of the Comprehensive Trail-making Test in adults.

Previous evaluation of the Comprehensive Trail-Making Test (CTMT) using a confirmatory factor analysis (CFA) revealed that for children, a two-factor model provided a better fit than did a one-factor model. The purpose of this study was to explore whether these findings suggested a developmental factor structure or if the two-factor structure also would be supported for adults. CFA was conducted using M-plus to examine the factor structure for adults in the standardization sample using all five trails tasks from the CTMT. The findings of the CFA indicated an excellent fit for the two-factor model. In contrast, the one-factor structure (i.e., use of a composite score) was not supported. Results were the same when younger (younger than 50 years of age) and older (50 years old or older) adults were considered separately. These data suggest that a single score may not be a valid representation of executive functioning. The results support a two-factor structure that represents attention/sequencing and set switching/inhibition.

Prevalence of low scores in children and adolescents on the test of verbal conceptualization and fluency.

It is important to consider the prevalence of low scores when administering a battery of psychological tests. Understanding the prevalence of low scores is important for minimizing false-positive diagnoses of cognitive deficits in clinical practice. The purpose of this study was to expand the literature on base rates for use in children and adolescents. Participants were 408 healthy children and adolescents (M(age) = 13.1 years, SD = 3.7) and 139 children and adolescents (M(age) = 12.4 years, SD = 3.1) diagnosed with a medical, neurological, or learning condition. All participants were administered the Test of Verbal Conceptualization and Fluency (TVCF; Reynolds & Horton, 2006 ). The clinical sample performed significantly lower compared with the healthy control participants on three of the five TVCF scores. When all scores were considered simultaneously, 38% of healthy children obtained one or more scores below the 16th percentile and 15% had one or more scores in the 5th percentile or lower. By comparison, significantly higher proportions of children in the clinical sample had low scores below each of the five cutoffs (i.e., 63% had one or more test scores below the 16th percentile and 37% had one or more scores in the 5th percentile or lower). Our findings illustrate the importance of considering the prevalence of low TVCF scores in everyday clinical practice with children and adolescents.

Developmental aspects of working and associative memory.

Developmental differences between working and long-term associative memory were evaluated through a cross-sectional age difference study based on data from a memory battery's standardization sample. The scores of 856 children and adolescents ranging from 5 to 17 years of age were compared on memory subtests that assess verbal working and long-term memory. Data were examined using curve fitting and ANOVA procedures that evaluated age group and years of age differences. The major finding was that the developmental trajectories across age differed substantially between the two memory domains. The working memory trajectory was linear until age 11, whereas the long-term memory trajectory was curvilinear with an inflection point at age 8. Both trajectories plateaued after age 11. ANOVAs produced significant interactions between tests of working and associative memory with age, supporting the view that the age trajectories had differing courses. The results are discussed in terms of neurobiological implications for the two memory systems studied.

Understanding and preventing violence directed against teachers: recommendations for a national research, practice, and policy agenda.

Violence directed against K-12 teachers is a serious problem that demands the immediate attention of researchers, providers of teacher pre-service and in-service training, school administrators, community leaders, and policymakers. Surprisingly, little research has been conducted on this growing problem despite the broad impact teacher victimization can have on schooling, recruitment, and retention of highly effective teachers and on student academic and behavioral outcomes. Psychologists should play a leadership role in mitigating school violence, including violence directed toward teachers. There is a need for psychologists to conduct research accurately assessing the types and scope of violence that teachers experience; to comprehensively evaluate the individual, classroom, school, community, institutional, and cultural contextual factors that might predict and/or explain types of teacher violence; and to examine the effectiveness and sustainability of classroom, school, and district-wide prevention and intervention strategies that target teacher violence in school systems. Collectively, the work of psychologists in this area could have a substantial impact on schooling, teacher experience and retention, and overall student performance.

Improving test interpretation for detecting executive dysfunction in adults and older adults: prevalence of low scores on the test of verbal conceptualization and fluency.

Knowing the prevalence of low scores on a battery of executive-functioning tests supplements clinical interpretation and can reduce the likelihood of misdiagnosing deficits in executive functioning. The purpose of this study is to examine the base rates of low scores on the Test of Verbal Conceptualization and Fluency (TVCF; Reynolds & Horton, 2006 ) in healthy adults (n = 332; M (age) = 33.0 years, SD = 10.5, range = 20-59) and older adults (n = 138; M (age) = 74.9 years, SD = 7.8, range = 60-89) from the TVCF standardization sample. The TVCF consists of four tests of executive functioning (i.e., Category Fluency, Letter Naming, Classification, and Trails C) that provide five age-adjusted T-scores. The prevalence of low scores was examined in the total sample and was stratified by educational level. When the five T-scores were considered simultaneously, having one or more scores that were 1 standard deviation (SD) below the mean was found in 28% of healthy adults and 38% of older adults. Education-based differences were also present with more lenient cutoff scores (e.g., 1 SD) but not with more conservative cutoffs. Consistent with the existing literature on other test batteries, at least one low subtest score on the TVCF is common in healthy adults and older adults.

Teacher-reported behavioral disturbances in children with traumatic brain injury: an examination of the BASC-2.

Pediatric traumatic brain injury (TBI) is associated with behavioral disturbances that can interfere with adjustment in the classroom. As such, standardized assessments of behavioral disturbances following TBI are useful in treatment planning and rehabilitation, although few studies have examined the sensitivity of standardized behavior assessments to behavioral abnormalities in this population. The present study compared the Behavior Assessment System for Children-Second Edition Teacher Rating Scale (BASC-2 TRS) profiles of 25 children who sustained TBI to those of 25 matched controls and to the BASC-2 standardization sample. Results indicated that teachers endorsed externalizing and school-related problems more severely and frequently than internalizing problems, with the greatest elevations on the Hyperactivity, Attention Problems, and Learning Problems subscales. In addition, BASC-2 scores appeared unrelated to IQ but were influenced by achievement functioning. Findings are consistent with previous studies of behavioral abnormalities in children with TBI and provide support for the usefulness of the BASC-2 TRS in evaluating behavioral disturbances in children that result from TBI.

Comprehensive trail-making test: gender and ethnic differences for ages 8 to 18 years old.

There is increasing concern for possible gender and ethnic differences on neuropsychological measures. The purpose of this study was to examine gender and ethnicity differences on the Comprehensive Trail-Making Test (CTMT) with a focus on individuals from 8 to 18 years of age. From the standardization sample, this included 251 boys and 306 girls with a mean age of 12.76 years (SD = 3.07 years) and who were predominantly White (81.51%). Only those participants who completed all five tasks that comprise the CTMT were considered; participants representing special groups were excluded. For ethnic group, no significant differences emerged; for gender, significant differences emerged; and no interaction effects for sex by ethnicity were found. Further, no differences based on ethnicity were found. Implications and possible explanations for this difference for practice and additional research are discussed.

Differential sensitivity of TOMAL subtests and index scores to pediatric traumatic brain injury.

The objective of the present study was to examine and compare the subtest, index, and factor scores of the Test of Memory and Learning (TOMAL), using receiver-operating characteristic curves, to investigate their sensitivity and specificity to traumatic brain injury (TBI) in children and adolescents. One hundred and fifty participants who had sustained TBI were compared to 150 controls matched on age and gender from the TOMAL's standardization sample. Results indicated that the greatest area under the curve (AUC) was for the Object Recall (OR) subtest score, the Composite Memory Index (CMI), and the attention factor score. The optimal CMI cutoff score for a TBI diagnosis was 83. When factor scores were compared, the attention factor and two verbal factors had significantly larger AUCs than the three nonverbal factors. These findings suggest that the OR subtest and CMI are most sensitive to TBI, and that when components were broken into factors with no overlapping subtests, attention and verbal memory were optimal for classifying TBI.

Confirmation of a two-factor model for interpretation of the comprehensive trail making test with children.

Exploratory factor analyses (EFAs) of the Comprehensive Trail Making Test suggested a possible two-factor solution that might better reflect the differences in Trails 1-3 and Trails 4 and 5 as opposed to a single Composite Index for the total standardization sample. The purpose of this study was to conduct a confirmatory factor analysis (CFA) of the two-factor structure with a subset of the standardization sample ages 18 or younger that had completed all five-trail tasks. The sample included 251 boys and 306 girls, ages 8-18, with a mean age of 12.76 (SD = 3.07). Data were collected across 16 states with representation from all regions of the USA. Standardized scores on each of the trails (1-5) tasks were considered. The results of CFA using M-plus indicated a good fit for the two-factor model, χ(2)(4) = 18.686, p = .0009, root mean-square error of approximation = 0.081, comparative fit index = 0.986 and standardized root-mean-squared residual = 0.021. A one-factor model was not supported. As suggested by the EFA in the manual, Trails 1-3 and Trails 4 and 5, while related, appear to be different in subtle ways that may be most meaningful in conjunction with evaluation of children with neurodevelopmental differences. Implications and possible explanations for this difference are discussed.

Behaviors that discriminate ADHD in children and adolescents: primary symptoms, symptoms of comorbid conditions, or indicators of functional impairment?

OBJECTIVE: The objectives of this study were to evaluate whether behaviors that differentiate children and adolescents with ADHD from those without are related to the primary diagnostic criteria (i.e., inattention and impulsivity-hyperactivity), symptoms of comorbid conditions, functional impairment, or a combination, and to determine whether behaviors that discriminate are consistent between the key developmental stages of childhood and adolescence. METHOD: Parents and teachers rated children and adolescents with a formal diagnosis of ADHD and those without any mental, physical, or emotional disorders on the multidimensional Behavior Assessment System for Children (2nd ed., BASC-2). RESULTS: Results indicated that behaviors that discriminate children and adolescents with ADHD from those without were associated with primary symptoms, symptoms of comorbid conditions, and indicators of functional impairment. Teachers rated atypicality as the strongest discriminator of children with ADHD from those without and learning problems as the strongest discriminator of adolescents. Parents rated hyperactivity as the strongest discriminator for children and attention problems for adolescents. Activities of daily living was the third strongest discriminator of adolescents as rated by parents. CONCLUSIONS: Findings supported the need for a multidimensional view of ADHD that adds emphasis to issues of functional impairment in routine, daily activities important to success in school and interpersonally. Findings showed that conceptualizing and assessing behaviors demonstrated by children and adolescents with ADHD as a whole instead of only equating a diagnosis of ADHD to hyperactivity, inattention, and impulsivity will establish a foundation for understanding, interpreting, and addressing students' academic and behavioral needs across the home and school.

Executive functions in children with traumatic brain injury.

The maturational course of the development of executive functioning abilities is dependent on the functional capacity of the human brain. Unfortunately, there is a dearth of standardized functional assessments of executive functioning abilities for children. The present article describes neurodevelopment of executive functioning and several recent measures of executive functioning that have been developed to assess maturational periods of specific executive functions. Clinical implications of these results for traumatically brain-injured children are described.

On becoming a peer reviewer for a neuropsychology journal.

The peer-review process is an invaluable service provided by the professional community, and it provides the critical foundation for the advancement of science. However, there is remarkably little systematic guidance for individuals who wish to become part of this process. This paper, written from the perspective of reviewers and editors with varying levels of experience, provides general guidelines and advice for new reviewers in neuropsychology, as well as outlining benefits of participation in this process. It is hoped that the current information will encourage individuals at all levels to become involved in peer-reviewing for neuropsychology journals.

Response to Intervention: Ready or Not? Or, From Wait-to-Fail to Watch-Them-Fail.

Response to Intervention (RTI) models of diagnosis and intervention are being implemented rapidly throughout the schools. The purposes of invoking an RTI model for disabilities in the schools clearly are laudable, yet close examination reveals an unappreciated paucity of empirical support for RTI and an overly optimistic view of its practical, problematic issues. Models are being put into practice without adequate research and logistical support and neglect the potential negative long-term impact on students with disabilities. Many implementation problems exist: (a) the vagaries of critical details of the model in practice; (b) the lack of consideration of bright struggling readers; (c) the relativeness, contextual, situation dependent nature of who is identified; (d) the worrisome shortcomings of the RTI process as a means of diagnosis or determination of a disability; and (e) the apparent lack of student-based data to guide effective choice of approaches and components of intervention. Practiced as a model of prevention, the authors agree with the concept of RTI. As the authors witness its application to disability determination sans the benefit of a reliable and valid empirical basis, the potential benefits to some children with disabilities remain an unproven hypothesis while the potential detriment to some children with disabilities remains a very real possibility.

Response to Intervention: Prevention and Remediation, Perhaps. Diagnosis, No.

Fletcher and Vaughn (this issue) describe recent changes to federal laws governing special education eligibility for specific learning disabilities focusing on what is commonly known as response to intervention (RTI). We are concerned about what appears to us as a selective review of empirical support for RTI and a consequently overly optimistic view of many practical issues surrounding the implementation of RTI models that neglects the potential negative long-term impact on the range of students with and without a learning disability. These include (1) the lack of a firm evidence base reflected in vagaries and ambiguity of the critical details of the model in practice; (2) the worrisome shortcomings of the RTI process as a means of diagnosis or determination of a disability; (3) the contextual, situation-dependent nature of who is identified; (4) the seeming lack of consideration of bright struggling readers in the RTI process; and (5) the apparent lack of student-based data to guide the most effective choice of approaches to, and specific components of, intervention.

Learning disabilities: the need for neuropsychological evaluation.

A learning disability (LD) is a neurobiological disorder that presents as a serious difficulty with reading, arithmetic, and/or written expression that is unexpected, given the individual's intellectual ability. A learning disability is not an emotional disorder nor is it caused by an emotional disorder. If inadequately or improperly evaluated, a learning disability has the potential to impact an individual's functioning adversely and produce functional impairment in multiple life domains. When a learning disability is suspected, an evaluation of neuropsychological abilities is necessary to determine the source of the difficulty as well as the areas of neurocognitive strength that can serve as a foundation for compensatory strategies and treatment options.