A psychological test must be individually administered. Tests that are designed for administration in group settings are not programmatically acceptable, even if they are administered individually in a specific situation.

A psychological test must be administered by a qualified specialist according to all prerequisite testing conditions. A qualified specialist is a person who is currently licensed or certified at the independent level of practice in the State where the test was performed, and has the training and experience to administer, score, and interpret psychological tests. Tests administered in a classroom by a teacher are not programmatically acceptable.

NOTE: If a psychological assistant or paraprofessional (e.g., a psychometrist) administered the test, then a supervisory qualified specialist must interpret the test findings and co-sign the examination report.

Psychological tests must be administered and scored in a predetermined, standard manner with consistent questions, conditions for administering, scoring procedures, and interpretations.

Psychological tests must meet contemporary psychometric standards for validity, reliability, appropriate normative data, and wide scope of measurement. Even when a psychological test meets these contemporary psychometric standards, consider and resolve any discrepancies between the formal test results and the person’s customary behavior and daily activities.

The test report must contain the name of the test administered and any subtests, the date of administration, the person administering the test (to determine whether the person is a qualified specialist), composite and individual subtest scores obtained during the test administration, and a narrative report.

Test results must be accompanied by a narrative report. While the format and content of the narrative report are up to the individual test administrator, the key elements of the report are statements about the validity of the test results and whether those results are an accurate reflection of the person’s mental functioning. Generally, narrative reports will also include information about whether the testing results are consistent with the person’s developmental history, the degree of functional limitation, and other useful information. For example, the report may include the specialist’s observations regarding the person’s abilities to sustain attention and concentration, to relate appropriately to the specialist, and to perform tasks independently without prompts or reminders.

NOTE: The "validity" of a test result refers to the psychometric standard described in 24583.050B.4.a above. However, you may also see the term "valid" used in evidence to describe whether test results are an accurate reflection of a person's functioning.

Intelligence tests are standardized tests that measure a person’s intellectual performance in multiple aspects of cognitive functioning. They may also be referred to as intelligence quotient or IQ tests. For more information about intelligence tests, see DI 24583.055.

Standardized tests of adaptive functioning are designed to measure how well a person uses conceptual, social, and practical skills to function in their daily life. Standardized tests of adaptive functioning may be used in clinical practice. These tests often rely on a third party, such as a parent or teacher, to rate a person's adaptive functioning. We do not require the results of an individually administered standardized test of adaptive functioning. Standardized tests of adaptive functioning may be purchased when appropriate. When contained in the case record, consider these test results along with all other relevant evidence when determining whether the person has significant deficits in adaptive functioning.

Academic achievement tests are used to measure how well the person has mastered basic academic skills such as reading, writing, and arithmetic. Some tests measure knowledge in specific content areas such as history or science. Academic achievement tests may be purchased when appropriate. When included in the record, consider academic achievement tests for the information they provide. Do not substitute academic achievement scores for IQ scores to determine whether the person’s mental impairments meets or medically equals listing 12.05 or 112.05.

When considering the criteria of listing 12.05 or 112.05, ensure the test being considered is an intelligence test and not an academic achievement test. For example, the Woodcock-Johnson Tests of Cognitive Abilities is an intelligence test but the Woodcock-Johnson Tests of Achievement is an academic achievement test. Only results from the Woodcock-Johnson Tests of Cognitive Abilities may be used to determine whether the mental impairment meets or medically equals the requirements of listing 12.05 or 112.05

Neuropsychological batteries are designed to establish the existence and extent of brain dysfunction that causes psychological symptoms. We do not require neuropsychological batteries to evaluate mental impairments, including those impairments considered under 12.02, neurocognitive disorders. Do not purchase neuropsychological batteries. However, consider the results of neuropsychological batteries when they are part of the medical evidence of record. If we need to purchase testing to fully evaluate a specific neuropsychological impairment, consider the precise elements we need addressed and purchase the specific tests that address those elements alone.

Memory tests are used to measure different memory functions in a person. Clarify any allegations of “memory problems” or “forgetfulness” with the person. Memory tests do not establish the existence of a memory disorder, such as an amnestic state or dementia. Additionally, memory problems are not diagnostic when they are symptomatic of another mental disorder, such as depression, are related to medication side effects, or cannot be distinguished from the person's typical or previous mental functioning.

Generally, memory tests are not necessary because memory can be adequately assessed in less formal ways, such as through a mental status examination. We neither require nor prohibit the purchase of memory tests. Decide whether a specific test of memory is necessary given the particular facts of a case.

Personality measures provide information about personality traits. The two most common types are self-reported inventories, where the person being tested rates how well a question or statement applies to them, and projective techniques, where the person is presented with a vague scene, object, or scenario and then asked to give their interpretation of the test item. Do not purchase personality measures. However, consider the results of personality measures when they are part of the medical evidence of record.

Screening tests are used to provide only gross determinations of levels of functioning. They are frequently used to determine whether a person needs more comprehensive evaluation and do not replace more comprehensive versions of psychological tests. Although the results of a screening test may suggest the presence of a mental impairment, additional evidence is required to establish the presence of a medically determinable mental impairment and any resulting functional limitations. Abbreviated or screening tests may be used to rule out a medically determinable impairment but cannot be used to establish a medically determinable impairment. Purchase screening tests only in rare circumstances. When screening tests are part of the record, consider whether the results indicate a need for further development or the need to purchase a consultative examination (CE).

Performance validity tests provide information about a person’s effort on tests of maximal performance, such as cognitive tests. Many psychological tests include embedded validity measures. Do not purchase specific performance validity tests. Consider embedded validity measures that are part of other psychological tests. Additionally, consider the results of performance validity tests when they are part of the medical evidence of record.

Symptom validity tests provide information about the consistency and accuracy of a person’s self-report of symptoms they are experiencing. We do not require symptom validity tests to evaluate mental impairments. Do not purchase symptom validity tests because they have limited usefulness in our program. However, consider the results of symptom validity tests when they are part of the medical evidence of record.

School records, including transcripts and individualized education programs (IEP), sometimes include the results of psychological tests such as academic achievement tests, standardized tests of adaptive functioning, or impairment-specific tests such as autism scales. Do not use the results of psychological tests reported in school records if only the score is documented. Only use the results of psychological tests reported in school records when the documentation includes the required test administration information and narrative report. For additional information about intelligence test results contained in school records, see DI 24583.050C.

Most providers will transition to updated editions within a reasonable period of time following the release of the updated edition due to State and national ethical codes and a need to keep current with advances in psychological testing. The provider is allowed to exercise professional judgment in selecting the most appropriate test instrument for a particular person. We expect this will usually be the most recently normed edition of the test. When considering tests for purchase as part of a CE, do not purchase tests more than two years after the publication of the new editions.