Basic (07-19)

DI 24583.060 Additional Guidelines for Using Psychological Tests to Evaluate Mental Disorders in Children

A. How are psychological tests used to evaluate childhood disability claims?

Psychological tests for children must satisfy the same requirements as psychological tests for adults. However, there are additional guidelines that are specific to psychological tests for children. For more information about psychological tests, see DI 24583.050. For more information about intelligence tests, see DI 24583.055.

B. When do these additional guidelines for children apply?

Follow these additional guidelines for children when evaluating standardized tests for a child who has not attained age 18. Use the person’s chronological age when determining whether these guidelines apply.

C. What are the specific guidelines for intelligence tests for children?

1. Current IQ scores

IQ scores must be current to be used to meet or medically equal the requirements of listing 112.05. IQ scores stabilize after age 16 and are generally considered current after that time. For younger children, consider the child's age at the time of test administration and the test results themselves when determining whether IQ test results obtained before age 16 are sufficiently current for adjudication. The general guidelines are:

Age at time of test administration

IQ less than 40

IQ 40 or greater

Before attainment of age 7

Current for 2 years

Current for 1 year

From age 7 to attainment of age 16

Current for 4 years

Current for 2 years

Intelligence test results obtained at age 16 or older may be considered current indefinitely, provided they are not inconsistent with the person’s current functioning.

NOTE: IQ scores that are not current may still provide useful information about whether a person’s intellectual disorder began during the developmental period. For example, a full scale IQ score of 88 obtained when the person was age 15 may provide evidence the intellectual disorder did not begin during the developmental period.

2. Scores that are slightly past being current

When a child has not attained age 16, the IQ scores may sometimes be only slightly past the requirements for being current. Consider how much time has passed since the test in the claim file was administered and whether the same test would be given currently. Do not use IQ scores that are more than 6 months beyond what is considered current to determine whether the child has an intellectual disorder that meets or medically equals listing 112.05.

EXAMPLE: An 8 year old child was administered the Stanford-Binet Intelligence Scales: Fifth Edition (SB-5) and received a full scale IQ score of 65 on June 22, 2014. The scores are considered current for program purposes until June 21, 2016. The claim is being adjudicated on August 15, 2016. Because the score is less than 6 months beyond what is considered current and the SB-5 would still be the appropriate test, updated testing would generally not be required to make a determination about whether the child has an intellectual disorder that meets or medically equals listing 112.05.

EXAMPLE: A 15 year old child was administered the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) and received a full scale IQ of 65 on June 22, 2014. The scores are considered current for program purposes until June 21, 2016. The claim is being adjudicated on August 15, 2016. Although the score is less than 6 months beyond what is considered current, the WISC-IV is no longer the same test that would be given because the child is now 17 years old and the WISC-IV is only appropriate for children through age 16 years and 11 months. Updated intelligence testing is required to make a determination about whether the child has an intellectual disorder that meets or medically equals listing 112.05.

NOTE: We do not endorse, prefer, or require any specific intelligence test. Tests are programmatically acceptable when they satisfy the requirements set out in DI 24583.050B and DI 24583.050C.

3. Overlap in test age ranges

The Wechsler series of intelligence tests have overlap in the age range for each test. For example:

Test name

Lower end

Upper end

Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition (WPPSI-IV)

2 years and 6 months

7 years and 7 months

Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V)

6 years and 0 months

16 years and 11 months

Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV)

16 years and 0 months

90 years and 11 months

When deciding which test to purchase for children in the overlap age ranges, test developers recommend choosing the test with the lower minimum age if the child is suspected of being of below average cognitive ability.

EXAMPLE: A child is 6 years and 9 months old and has suspected low cognitive ability. Purchase the WPPSI-IV and not the WISC-V for this child because the WPPSI-IV is the test with the lower end of the age range.

NOTE: We do not endorse, prefer, or require any specific intelligence test. While the Wechsler series of intelligence tests are frequently seen in our program, there are other intelligence tests that satisfy our program requirements for acceptable intelligence tests and may also be purchased when appropriate.

D. How do we use age- and grade-equivalent scores when evaluating children?

Some test reports, particular reports from achievement tests, contain information about age and grade equivalence.

1. Definitions

a. Raw score

A raw score is the unconverted score on a standardized test.

b. Age-equivalent score

An age-equivalent score is the average age of children who received the same raw score on a standardized test.

c. Grade-equivalent score

A grade-equivalent score is the grade and month of the school year that is the average grade placement for students who received the same raw score on a standardized test.

2. Use of age- and grade-equivalent scores

Age- and grade-equivalent scores represent average scores and are not standard scores that can be converted to standard deviations. Because we compare the child to other children his or her age, an age- or grade-equivalent score by itself has limited usefulness since it does not indicate how well the child did in comparison to other children his or her age who do not have impairments. Do not rely on any test score alone. Consider the information from the test along with all the other evidence. These scores, along with other information, may give a picture of the child's overall progress in development or learning.

E. How do we evaluate developmental milestone criteria?

Developmental milestones refer to the attainment of particular mental or motor skills at an age-appropriate level. Developmental milestone criteria are used for determining disability when a child’s young age or condition precludes formal standardized testing.

Only consider developmental milestone criteria for children who have not attained age 3. Consider developmental milestone criteria for these children in combination with professional observations of a child’s performance, behavior, and activities. Consider whether findings about developmental milestones are consistent with the child’s daily activities and with professional observations of the child’s performance and behavior. Do not substitute statements by relatives or other parties regarding the child’s behavior or capabilities for professional observations.

F. How do we consider psychological tests that are specific to a particular disorder?

Psychological tests are sometimes used in the clinical setting as part of the diagnostic process. These diagnostic tests are often specific to particular disorders, such as autism spectrum disorder. Generally, diagnostic testing is not necessary to evaluate mental disorders in children because the disorders can be adequately assessed using other findings available in the medical evidence. We do not require the results of diagnostic tests to make a determination about whether a medically determinable impairment (MDI) exists, the severity of that MDI, or whether the MDI meets or medically equals a listing. We neither require nor prohibit the purchase of diagnostic tests. Decide whether a specific standardized test typically used in the diagnostic process is necessary given the particular facts of a case.

G. References

  • DI 24583.050 Using Psychological Tests to Evaluate Mental Disorders

  • DI 24583.055 Using Intelligence Tests to Evaluate Cognitive Disorders, Including Intellectual Disorder

  • DI 34005.112 Mental Disorders (Listing of Impairments – Child Listings (Part B))


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DI 24583.060 - Additional Guidelines for Using Psychological Tests to Evaluate Mental Disorders in Children - 07/19/2019
Batch run: 07/19/2019
Rev:07/19/2019