Ethics in Testing: Rights,
Responsibilities, and Fairness
Chapter Questions
• What are basic elements of informed consent
for clinical assessment of children and
adolescents?
• What does it mean that interpretations from
tests should be “evidence-based?”
• When could releasing test material be
problematic?
• What types of accommodations are appropri-
ate for testing children or adolescents with a
disability?
• What is measurement bias?
Standards for Educational
and Psychological Testing
In the previous chapters, we have focused on key
issues from research that are critical for the clini-
cal assessment of children and adolescents. As
part of this discussion, we have highlighted a
number of important issues related to measure-
ment theory, the science of classification, and
developmental psychopathology research that
impact how one should evaluate and select tests
for clinical assessments. However, the majority
of problems that occur in the clinical assessment
of children and adolescents are not due to inher-
ent flaws in the tests but to the inappropriate use
of tests and the misinterpretation of their results
by clinicians (Anastasi, 1992). Test use is not
© Springer Nature Switzerland AG 2020
P. J. Frick et al., Clinical Assessment of Child and Adolescent Personality and Behavior,
https://doi.org/10.1007/978-3-030-35695-8_4
4
unlike automobile use in that most accidents are
caused by driver error, not by the way the car was
made. Even widely used and accepted tests can
cause harm to clients if they are not used, scored,
or interpreted properly (Eyde et al., 1993).
Consequently, the practice of psychological
assessment has long been governed by two pri-
mary sources of ethical guidelines. The first is
the Ethical Principles of Psychologists and Code
of Conduct developed and published by the
American Psychological Association (APA,
2016). This is an omnibus set of ethical princi-
ples to guide the practice of psychology in all
areas, including clinical assessment. The
Standards for Educational and Psychological
Testing (Standards) are guidelines and standards
that are prepared jointly by the American
Educational Research Association (AERA), the
American Psychological Association (APA), and
the National Council on Measurement in
Education (NCME) specifically to guide test use
in clinical assessments. The most recent version
of these Standards were published in 2014
(AERA, APA, NCME, 2014).
The Standards were developed based on the
premise that “effective testing and assessment
require that all professionals in the testing pro-
cess possess the knowledge, skills, and abilities
necessary to fulfill their roles, as well as an
awareness of personal and contextual factors
that may influence the testing process” (p. 5;
AERA, APA, NCME, 2014). Thus, we feel that
61
62
anyone involved in the clinical assessment pro-
cess should be familiar with the both the Ethical
Principles and the Standards and have a copy of
them available for periodic reference. Further,
any class devoted to training clinical assessors
should have both of these guides as required
reading.
In this chapter, we will not provide an exhaus-
tive restatement of all of the important points
made by either the APA Ethical Principles or the
Standards. In Table 4.1 we provide a summary of
the content of the Standards. Many of the
Standards relate to material covered in other
parts of this text. For example, issues related to
validity (Standards, Section 1), reliability
(Standards, Section 2), and norm-­ referenced
scores (Standards, Section 5) were covered in
the chapter on Measurement Issues (Chap. 2).
Issues related to scoring, reporting, and interpre-
tation are covered in more detail in our chapter
on Integrating and Interpreting Assessment
Information (Chap. 15) and Report Writing
(Chap. 16). Also, some parts of the standards
cover areas that are not directly relevant to the
clinical assessment of child and adolescent per-
sonality and behavior, such as the sections on
test design and development (Standards, Section
4), workplace testing and credentialing
(Standards, Section 11), and use of tests for pro-
gram evaluation, policy studies, and account-
ability (Standards, Section 13). Instead, in this
chapter, we attempt to highlight a few issues that
we have found to be especially important to the
clinical assessment of children and adolescents
and constitute the basics of fair and ethical prac-
tice in testing.
 ights and Responsibilities of Test
R    (d) Cluster 4. Standards for Test Revision
Users
Informed Consent
Before providing any clinical service to a child
are adolescent, it is both a legal and ethical
requirement to obtain informed consent for these
services. A sample consent form is provided in
Box 4.1. As illustrated in this form, the basic ele-
ments of informed consent are:
4 Ethics in Testing: Rights, Responsibilities, and Fairness
Table 4.1 Content in the Standards for Educational and
Psychological Testing (AERA, APA, NCME, 2014)
Part 1. Foundations
 1. Validity
   (a) Cluster 1. Establishing Intended Uses and
Interpretations
   (b) Cluster 2. Issues Regarding Samples and
Settings Used in Validation
   (c) Cluster 3. Specific Forms of Validity Evidence
 2. Reliability/Precision and Errors of Measurement
   (a) Cluster 1. Specifications for Replications of
the Testing Procedure
   (b) Cluster 2. Evaluating Reliability/Precision
   (c) Cluster 3. Reliability/Generalizability
Coefficients
   (d) Cluster 4. Factors Affecting Reliability/
Precision
   (e) Cluster 5. Standard Errors of Measurement
   (f) Cluster 6. Decision Consistency
   (g) Cluster 7. Reliability/Precision of Group
Means
   (h) Cluster 8. Documenting Reliability/Precision
 3. Fairness in Testing
   (a) Cluster 1. Test Design, Development,
Administration, and Scoring Procedures That
Minimize Barriers to Valid Score Interpretations for
the Widest Possible Range of Individuals and
Relevant Subgroups
   (b) Cluster 2. Validity of Test Score
Interpretations for Intended Uses for the Intended
Examinee Population
   (c) Cluster 3. Accommodations to Remove
Construct-Irrelevant Barriers and Support Valid
Interpretations of Scores for Their Intended Uses
   (d) Cluster 4. Safeguards against Inappropriate
Score Interpretations for Intended Uses
Part 2. Operations
 4. Test Design and Development
   (a) Cluster 1. Standards for Test
   (b) Cluster 2. Standards for Item Development
and Review
   (c) Cluster 3. Standards for Developing Test
Administration and Scoring Procedures and
Materials
 5. Scores, Scales, Norms, Score Linking, and Cut
Scores
   (a) Cluster 1. Interpretations of Scores.
   (b) Cluster 2. Norms
   (c) Cluster 3. Score Linking
   (d) Cluster 4. Cut Scores
 6. Test Administration, Scoring, Reporting, and
Interpretation
   (a) Cluster 1. Test Administration
   (b) Cluster 2. Test Scoring
(continued)
Rights and Responsibilities of Test Users
Table 4.1 (continued)
   (c) Cluster 3. Reporting and Interpretation
 7. Supporting Documentation for Tests
   (a) Cluster 1. Content of Test Documents:
Appropriate Use
   (b) Cluster 2. Content of Test Documents: Test
Development
   (c) Cluster 3. Content of Test Documents: Test
Administration and Scoring
   (d) Cluster 4. Timeliness of Delivery of Test
Documents
 8. The Rights and Responsibilities of Test Takers
   (a) Cluster 1. Test Takers’ Rights to Information
Prior to Testing
   (b) Cluster 2. Test Takers’ Rights to Access Their
Test Results and to Be Protected From
Unauthorized Use of Test Results
   (c) Cluster 3. Test Takers’ Rights to Fair and
Accurate Score
   (d) Cluster 4. Test Takers’ Responsibilities for
Behavior throughout the Test Administration
Process
 9. The Rights and Responsibilities of Test Users
   (a) Cluster 1. Validity of Interpretations
   (b) Cluster 2. Dissemination of Information
   (c) Cluster 3. Test Security and Protection of
Copyrights
Part 3. Test Applications
 10. Psychological Test and Assessment
   (a) Cluster 1. Test User Qualifications
   (b) Cluster 2. Test Selection
   (c) Cluster 3. Test Administration
   (d) Cluster 4. Test Interpretation
   (e) Cluster 5. Test Security
 11. Workplace Testing and Credentialing
   (a) Cluster 1. Standards Generally Applicable to
Both Employment Testing and Credentialing
   (b) Cluster 2. Standards for Employment Testing
   (c) Cluster 3. Standards for Credentialing
 12. Educational Testing and Assessment
   (a) Cluster 1. Design and Development of
Educational Assessments
   (b) Cluster 2. Use and Interpretation of
Educational Assessments
   (c) Cluster 3. Administration, Scoring, and
Reporting of Educational Assessments
 13. Uses of Test for Program Evaluation, Policy
Studies, and Accountability
   (a) Cluster 1. Design and Development of Testing
Programs and Indices for Program Evaluation,
Policy Studies, and Accountability Systems
   (b) Cluster 2. Interpretations and Uses of
Information from Tests Used in Program
Evaluation, Policy Studies, and Accountability
Systems
63
• A description of the facility (e.g., an outpa-
tient service of St. Agnes Hospital) and the
qualifications of the person(s) providing the
evaluation
• A description of the purpose of the
evaluation
• A summary of the planned procedures, includ-
ing how the results will be provided to the
child and his/her parents
• A summary of the potential benefits of the
procedures
• A summary of the potential risks and discom-
forts associated with the procedures
• A statement of the right to refuse and descrip-
tion of alternative services
• A description of protections for confidential-
ity, including how records will be stored, who
is legally authorized to obtain the results of
the evaluation, and when confidentiality is
legally required to be broken (e.g., suspected
cases of child or elder abuse, imminent dan-
ger of harm to self or others, third-party pay-
ers for the services)
• A description of the fee for the services
For children and adolescents below the “age of
consent,” the informed consent must be
obtained from at least one of the child’s parents
or legal guardians. Jurisdictions can have
varying laws governing the legal age of consent,
which is the age at which a child or adolescent
can seek medical or psychological services
without parental consent. Further, laws can
vary in terms of whether parents have a right to
the child’s information, even if the child has
reached the age of consent (Kerwin et al.,
2015). Finally, clinics providing services can
have policies that are more restrictive than the
law, such as requiring both parents to provide
consent and/or requiring both parent and child
consent, even after the child has reached the
age of consent. Thus, it is imperative that
assessors are knowledgeable about all
applicable laws and policies that govern their
services, so that these can be strictly adhered to
and accurately conveyed during informed
consent.
64 4 Ethics in Testing: Rights, Responsibilities, and Fairness

Box 4.1 Sample Parental Consent Form for Clinical Assessments of Children and Adolescents

PARENTAL CONSENT FORM

Service: Caring Huskies Assessment Service

Performance Site: Psychological Services Center,

31 Testing Lane
Kenilworth, LA 70803.
225 – XXX-XXXX

Clinical Supervisor: Paul J. Frick, Ph.D.

Department of Psychology
Louisiana License Number: XXXX

This is to certify that I, __________________________, as legal guardian of my minor child,

______________________, provide consent for my child to undergo a comprehensive psychological
evaluation through the Caring Huskies Assessment Service (C-HAS). I understand that C-HAS is a
service provided by the Psychological Services Center. The Psychological Services Center is a teaching
clinic and the persons conducting the evaluation will be students or faculty at Local University. Because
this is a teaching facility, the procedures may be observed, videotaped, or audiotaped for training
purposes.

Purpose of the Service: The purpose of this clinic is to provide a comprehensive, state-of-the-art,
affordable psychological assessment of children and adolescents who are experiencing behavioral,
emotional or learning problems. The results of the evaluation will be summarized in a report that will be
reviewed with my child and me. This report will include recommendations on interventions that may
enhance my child’s adjustment.

Procedures:
a. I will be asked questions about my child’s interests, friends, attitudes, emotions, and
behaviors. I will also be asked questions about my neighborhood, my family, and my
emotions and behaviors.

b. My child will be asked questions about his/her interests, attitudes, emotions, and
behaviors. He/she will also be asked questions about our family, his friends, his
neighborhood, and his school. He/she will participate in tasks that assess his/her thoughts,
emotions, and behaviors.

c. My child will be given standardized tests assessing his/her intelligence and learning.

d. My child’s teacher will be asked to answer questions and complete rating scales assessing
my child’s emotions, behavior, and learning at school.

e. The study procedures will take between 6 to 8 hours.

Benefits: The benefit will be a thorough psychological assessment of my child or adolescent and a report
making recommendations for any interventions that may help him or her.

Risks/Discomforts: Some persons may not feel comfortable answering personal questions about their
emotions and behaviors. The purpose of asking particular questions will be explained to me and my child
and I and my child can refuse to answer specific questions, although this may limit the conclusions that
can be made in the final report.

(continued)
Rights and Responsibilities of Test Users 65

Box 4.1 (continued)

Right to Refuse and Alternatives: Since this is a service that I have voluntarily requested for my child, I
can discontinue the testing at any time. I also recognize that similar services may be available at other
mental health clinics.

Privacy: Records with identifying information will be kept in a locked file cabinet that can only be
accessed by approved C-HAS staff. The information from the evaluation will not be shared with anyone
without a signed release by me or another legal guardian of my child. The only exceptions are if someone
is in imminent danger of harming themselves or others, if information is provided on current or past child
or elder abuse, or if I attempt to receive third-party payment for services.

Financial Information: The cost for participation in this study is ____________. Payment in full is
required prior to testing. Participants who withdraw will pay a pro-rated fee based on the assessments
given and the time involved.

Signatures:
I consent for my child to receive the services described above.

____________________________________ ________________________
Parent/guardian Signature Date

*Reader of the consent form, please sign the statement below if the consent form was read to the parent
because he/she is unable to read: The parent/guardian has indicated to me that he/she is unable to read. I
certify that I have read this consent form to the parent/guardian and explained that by completing the
signature line above, he/she has provided consent for their child to receive the services listed above.

____________________________________ ________________________
Signature of Reader Date

Importantly, children under the age of consent
cannot legally provide informed consent for
services. However, children still have the right to
have the policies and procedures explained to
them in a language that is appropriate to their
development level. As noted in the APA Ethical
Principles, for persons who are legally incapable
of giving informed consent, psychologists
nevertheless:
• “provide an appropriate explanation,
• seek the individual’s assent, and
• consider such persons’ preferences and best
interests” (3.10; APA, 2016).
To highlight the key parts of this principle, the
child being tested should receive a description
of the testing procedures, and this explanation
should be tailored to the child’s development
level. How to describe testing to children at
different ages is discussed in more detail in the
next section covering rapport building strate-
gies. The one notable difference in the informed
consent given to parents and legal guardians and
these “assent procedures” for the child is that the
child is not provided the right to refuse partici-
pation. Instead, the assessor should consider the
child’s preferences and best interests. This dif-
ference is based on the notion that minors are
not yet capable of weighing the costs and bene-
fits of receiving services in order to make
informed decisions on the receipt of services. A
form that can be used to document this “assent”
procedure is provided in Box 4.2.
Another way that jurisdictions can vary is in
the reporting child abuse. Psychologists are
typically mandatory reporters of abuse, which
means that they are legally mandated to report
any suspected cases of child abuse (both physical
and sexual) and neglect. However, jurisdictions
66 4 Ethics in Testing: Rights, Responsibilities, and Fairness

Box 4.2 Sample Child Assent Form for Clinical Assessments of Children and Adolescents

CHILD ASSENT FORM

Service: Caring Huskies Assessment Service

My parents have request that I undergo a comprehensive psychological evaluation through the Caring
Huskies Assessment Service (C-HAS).

This services will involve the following procedures:

a. My parent will be asked questions about my interests, attitudes, emotions, and behaviors.
I will also be asked questions about my neighborhood, my family, and my emotions and
behaviors.

b. I will be asked questions about my interests, attitudes, emotions, and behaviors. I will
also be asked questions about my family, friends, neighborhood, and school. I will also
participate in tasks that assess my thoughts, emotions, and behaviors.

c. I will be given standardized tests assessing my intelligence and learning.

d. My teacher will be asked to answer questions and complete rating scales assessing my
emotions, behavior, and learning at school.

e. The procedures take between 6 to 8 hours.

Since this is a service that my parent has voluntarily requested for me, my parent can stop the testing at
any time.

All of the information obtained during the evaluation will be summarized in a report that will be reviewed
with my parent and me. The information from the evaluation will not be shared with anyone else without
the permission of my parent or legal guardian. The only exceptions are if someone is going to hurt
themselves or others or if someone is hurting a child, including me.

____________________________________ ________________________
Child Signature Date

____________________________________ ________________________
Witness Date

*Witness must be present for the assent process, not just the signature by the minor.

can vary in terms of the definitions of abuse and
neglect and how and to whom such reports of
abuse should be made. Again, it is thus
imperative that assessors are knowledgeable
about all applicable laws and policies that
govern the reporting of abuse, so that these can
be strictly adhered to and accurately conveyed
during informed consent.
One final note about informed consent is that
it should be the first thing done in a clinical
assessment, without exception. That is, clini-
cians can be tempted to start their therapeutic
relationship off with something less formal than
reviewing the basic elements of informed con-
sent in order to help the parent and child become
comfortable with the clinic. In addition, a parent
Rights and Responsibilities of Test Users
may be anxious to tell the clinician about their
concerns and why they are having their child
tested without waiting to complete the consent
procedures. However, it is imperative that par-
ents be fully informed about the testing process
and their rights and responsibilities prior to
starting the assessment. As noted in the next
chapter, this actually can help establishing rap-
port by making it clear that both the parent and
child are informed participants in the assessment
process by clearly explaining everything that
will be done during the evaluation. Also, a par-
ent should be fully informed on the limits to
confidentiality before they potentially provide
information that the assessor may be legally
required to disclose (e.g., suspected cases of
child of abuse).
Competent Use
A critical ethical principle guiding test adminis-
tration is that that an assessor should only admin-
ister tests for which he or she is competent. As
stated by the Standards (i.e., Standards 6.0):
Those responsible for administering, scoring,
reporting, and interpreting should have sufficient
training and supports to help them follow the
established procedures. (p. 114; AERA, APA,
NCME, 2014)
Tests can vary greatly in how much training is
needed to be proficient at their administration,
scoring, and interpretation. However, all tests
specify a minimal level of training, and this typi-
cally includes both didactic and practical (i.e.,
supervised practice) training. It is incumbent on
the assessor to assure that this specified level of
competence is achieved before using a test in a
clinical assessment.
When developing competencies, most clinical
assessors focus on learning and mastering the
administration and scoring of individual tests.
However, we feel that there are also some more
general competencies that are important for ade-
quately conducting clinical assessments of chil-
dren and adolescents. This view led to the content
of this text. Specifically, assessors should have
both didactic and supervised experience in:
67
• Ethical principles related to testing children
and adolescents (Chap. 4)
• Measurement/psychometric theory (Chap. 2)
• Developmental psychopathology research
(Chap. 3)
• Research on common problems in develop-
ment experienced by children and adolescents
(Chaps. 17, 18 and 19)
Thus, a critical component of the principle of
“competent use” in psychological assessment is
that clinical assessors should be competent in the
methods used (i.e., be a competent user).
However, just as importantly, the assessor should
engage in competent test administration (i.e.,
competent use). These are related but not identi-
cal issues. That is, a person can have adequate
training and competency in the tests administered
but fail to engage in appropriate administration
procedures. There are two main parts to compe-
tent use. First, Standard 6.1 of the Standards
states that, “test administrators should follow
carefully the standardized procedures for admin-
istration and scoring specified by the test devel-
oper” (p. 114, AERA, APA, NCME, 2014).
Second, testers need to ensure that administration
procedures avoid introducing “construct-irrele-
vant variance” into the testing process. Construct-
irrelevant variance refers to factors that affect a
person’s performance on a test that are unrelated
to the construct that is being measured. For
example, noises and other disruptions in the test-
ing area, extremes of temperature, poor lighting,
illegible materials, and malfunctioning comput-
ers can all influence a person’s performance on a
test. Unless the goal of the test is to assess the
child’s performance under certain conditions
(e.g., ability to ignore distractions), these influ-
ences then could add variability to the child’s
performance that is not related to the skill or trait
being assessed.
These factors are all related to the administra-
tion of tests. Similar issues are related to scoring
the test. Like administration, scoring procedures
can vary greatly in terms of their difficulty, with
some requiring quite detailed coding of responses
and others requiring simply entering responses
into a computer. Problems with the former can
68
result from inadequate training, and problems in
the latter can result from carelessness. In both
cases, however, such errors can lead to scores that
lead to invalid interpretations about the child
being tested.
Evidence-Based Interpretation
Making accurate interpretations from test scores
should be the primary focus of clinical assess-
ments. As noted in the previous chapter, one of
the most common misapplications of measure-
ment theory is the view that tests are either valid
or invalid. This issue is not just a problem in
clinical assessment: the method sections of
most journal articles often have statements
describing a measure used in the study as “reli-
able and valid.” This is really a nonsensical
statement. To illustrate why this is problematic,
a self-report measure of depression may have
evidence to support its ability to assess the level
of depression in adolescents, but this does not
mean it is valid as a measure of conduct prob-
lems or impulsivity. Further, it may require a
reading level that makes it inappropriate for
very young children. Also, it may have content
that assesses a normative range of negative
affectivity well but not capture more problem-
atic indicators of major depression. Thus, per-
haps one of the most important ethical principles
related to clinical assessments is that only inter-
pretations that have been supported by research
(i.e., that are evidence-­based) should be made
from test scores.
There has been extensive discussion about the
need to have evidence-based clinical practice.
However, this has largely focused on using
empirically supported treatments. Also, it has led
to important discussions as to how to define
“empirically supported” or, to state this another
way, how much evidence is enough to warrant the
use of a particular treatment (Weisz & Hawley,
1998). We would argue that such an evidence-
based approach to practice is equally important
to clinical assessments.
Similar to interventions, there can be great
variability in how much evidence is available to
4 Ethics in Testing: Rights, Responsibilities, and Fairness
support certain interpretations from a test (Frick,
2000). As stated by the APA Ethical Principles:
Psychologists base the opinions contained in their
recommendations, reports, and diagnostic or eval-
uative statements, including forensic testimony,
on information and techniques sufficient to sub-
stantiate their findings. (9.01; APA, 2016)
However, there can be disagreement as to when
the evidence is “sufficient” to substantiate the
findings. The basic principle, however, is that
assessors know the degree of support that
research has provided for the interpretations
that are being made from a test and accurately
reflect this level of support when conveying test
results to others. To aid in this important clini-
cal decision-making process, we have devel-
oped a few self-monitoring questions that
clinicians can use:
1. On what assessment results (e.g., elevations
on a rating scale) am I basing this interpreta-
tion (e.g., the child has clinical levels of
depression)?
2. Does the measure that led to this interpreta-
tion have adequate evidence to support its reli-
ability in samples with similar demographics
to those of the person being tested (e.g., sex,
age, race, ethnicity, socioeconomic status,
geographic region, language, etc.)?
3. Has the measure that led to this interpretation
been evaluated in research, and is there ade-
quate evidence to support this interpretation
(e.g., high levels of sensitivity and specificity
for predicting a clinical diagnosis of
depression)?
4. Was the measure that led to this interpretation
administered in a standardized manner and
was it administered and scored in way that
limited factors that could lead to construct-­
irrelevant variance?
Explaining Assessment Results
Another important ethical principle guiding clini-
cal assessments is the importance of explaining
the results to the individual being tested in devel-
opmentally appropriate language. That is:
Rights and Responsibilities of Test Users
Psychologists take reasonable steps to ensure that
explanations of results are given to the individual
or designated representative, unless the nature of
the relationship precludes provision of an expla-
nation of results (such as in some organizational
consulting, pre-employment or security screen-
ings, and forensic evaluations), and this fact has
been clearly explained to the person being
assessed in advance. (9.10; APA, 2016)
An important part to this principle is the need to
provide “an explanation of results.” That is, we
do not feel it is sufficient to mail test results to
parents and allow them to call if they have ques-
tions. We feel that it is imperative that the clinical
assessor “take reasonable steps” to discuss the
results of an evaluation with the parent and child,
preferably in person, and allow both the parent
and child to ask questions and fully understand
the results and their implications. This explana-
tion includes a discussion of any diagnosis made
as a result of the testing.
In Chap. 16, we provide recommendations for
how to communicate test results to parents,
teachers, and children. As we note in this discus-
sion, this description needs to be tailored to par-
ents’ educational level and to the child’s
developmental level. For example, we do not rec-
ommend that young children necessarily be
given “diagnostic terms” like Attention-deficit/
Hyperactivity Disorder, until they can adequately
understand what such a term means. In fact, for
young children, the use of such terms could actu-
ally hurt the child’s understanding of the testing
results. Instead, describing the child as having a
weakness in his ability to keep his mind on things
and stay seated that is making it hard to learn in
school would be more understandable to a young
child than the use of a diagnostic term.
Maintaining Confidentiality
As noted in our discussion of informed consent,
it is critical that clinical assessors make clear to
both the child being tested and his or her parents
how the confidentiality of results will be pro-
tected and what limits to this confidentiality are
required by law. The issue of confidentiality is
worth additional comment because:
69
psychologists have a primary obligation and take
reasonable precautions to protect confidential
information obtained through or stored in any
medium. (4.01; APA, 2016)
A few critical questions should be considered for
protecting confidential testing information:
• How will test information be stored and access
limited to only authorized staff?
• What are the procedures that will be used to
assure that the release of information is only
made with appropriate consent and to autho-
rized individuals?
• How can the confidentiality of test informa-
tion be ensured during the scoring process?
• How can discussions of case material be lim-
ited to only those situations in which privacy
can be assured?
One final issue related to the confidentiality of
test material is when a clinical assessor should
not release information, even with the consent of
the person being tested, or in the case of children
and adolescents below the age of consent, even
with parental consent. The most important of
these instances is to “protect a client/patient or
others from substantial harm or misuse or mis-
representation of the data or the test” (9.04; APA,
2016). A common example of this is when the
testing is outdated and may lead to erroneous
interpretations of the child’s current functioning.
Another example is when a client requests that
raw test material (e.g., child or parent’s directs
responses to test questions or stimuli) to be
released to someone who is not qualitied to accu-
rately interpret the results.
 aintaining Security of Testing
M
Material
One final ethical issue related to clinical assess-
ments does not involve individual clients but
relate to protecting the integrity of the test mate-
rial themselves. “Testing materials” refer to
manuals, instruments, protocols, and test ques-
tions or stimuli that are used in standardized
assessments. It can be challenging to maintain
70
the security of test content given that many
sources may request access to records, such as
requests from parents, lawyers, or patients
themselves to see the actual record forms used
for the evaluation. Some internet sites even pro-
vide sample items that are analogous to items
found on popular tests, such as the MMPI-2 or
the Rorschach. However, such test content
should be shielded from would-be test takers.
Without such security, the content could be mis-
used by unqualified persons, resulting in harm
to others. Also, if clients have access to test
material prior to testing, this could invalidate
their performance on the material under the
standardized testing situation. Thus, when faced
with questions about test security, clinical asses-
sors should:
• Explain the problems associated with release
of items for the ability to practice psychologi-
cal assessment with others and
• Release test material only to other profession-
als qualified to interpret them properly for the
person making the request.
Fairness
Fairness During the Testing Process
A critical consideration in the ethical and accu-
rate conduct of clinical assessments is the issue
of “fairness.” The Standards provide an overall
definition of fairness as:
Responsiveness to individual characteristics and
testing contexts so that test scores will yield valid
interpretations for intended uses. (p. 50; AERA,
APA, NCME, 2014)
The Standards also distinguish between fairness
in how the person being tested is treated during
the testing process and fairness in how the results
of testing are interpreted. With respect to
former:
Regardless of the purpose of testing, the goal of
fairness is to maximize, to the extent possible, the
opportunity for test takers to demonstrate their
standing on the construct(s) the test is intended to
measure. (p. 50; AERA, APA, NCME, 2014)
4 Ethics in Testing: Rights, Responsibilities, and Fairness
Most clinical assessors are very familiar with
the concept of making “accommodations” in
tests for persons with disabilities, whereby test
administration procedures are modified to adapt
to a person’s disability in order to obtain a more
accurate estimate of a person’s performance. An
example would be using a Braille test form or
large print answer sheets for someone who may
be visually impaired. Another example would be
using voice-administered questions on a person-
ality inventory for a child who has a reading dis-
ability. Many such accommodations are intuitive
and enhance the accuracy of the test results.
However, the difficulty comes in when deciding
if any accommodations break the standardiza-
tion of the tests in way that would decrease the
accuracy of the test scores and resulting inter-
pretations. That is, many tests require strict
adherence to administration procedures, such as
uniform directions, specific time limits, and even
specific ways in which the room is arranged in
order to interpret the tests. Such standardization
allows the scores to be compared to the scores of
others who were tested under the same condi-
tions. If these procedures are not followed, it
makes comparisons to the performance of others
tested under different conditions questionable.
Further, accommodations that inherently change
the skill or ability being assessed also would
lead to erroneous interpretation of the test
results. For example, allowing a child unlimited
time to complete a task measuring his or her
speed of processing information would obvi-
ously invalidate the results of the testing.
Many tests provide instructions for making
accommodations for persons with disabilities and
provide evidence to support the comparability of
scores and interpretations when these modifica-
tions are used. In these cases, assessors can con-
fidently make evidence-based modification.
However, in some cases, such evidence may not
be available. Thus, clinical assessors should con-
sider two key questions when testing children
and adolescents with disabilities:
• Can the testing procedures be modified to
accommodate to the child’s disability in a way
that will enhance and not reduce the accuracy
of results?
Fairness
• If not, is the test appropriate for this child,
given his or her disability?
Accommodating to the needs of individual
children and adolescents in the clinical assess-
ment process goes beyond testing persons with
disabilities. Similar considerations should be
made when testing individuals from diverse lin-
guistic, cultural, ethnic, racial, and socioeco-
nomic backgrounds as well. Again, the same two
questions are imperative to consider:
• Can the testing procedures be modified to
accommodate to the child’s background in a
way that will enhance and not reduce the
accuracy of results?
• If not, is the test appropriate for this child,
given his or her background?
Such modifications can range from testing the
child in the language in which he or she is most
proficient to other modifications that enhance the
child’s comfort with who is conducting the test
and with the setting in which the test is
administered.
 airness and Lack of Measurement
F construct of interest, and, as we discussed in
Bias
The next issue critical for fairness in clinical
assessment is whether the test measures the
construct of interest in the same way across
different groups of individuals. Stated another
way, this issue focuses on whether the interpre-
tations that can be made from the test results are
equally valid across different groups of individ-
uals. If the validity of the interpretations are not
equally valid across groups, this is evidence of
“test bias” or “measurement bias” (Kamphaus,
2001). Thus, this issue is a specific instance of
the broader principle of evidence-based inter-
pretations that was discussed previously in this
chapter, whereby assessors only make interpre-
tations from test scores that have been validated
in research. This makes it more specific by
focusing on the fact that assessors should only
make interpretations from test scores that have
71
been validated in research for the specific group
of persons that includes the person being tested.
In this section, we cover some important con-
cepts that specifically relate to this form of test
validity and how to avoid making biased inter-
pretations from test results.
Test Bias Differential item functioning (DIF) is
said to occur when equally able test takers differ
in their probabilities of answering a test item
correctly as a function of group membership.
This can lead to different groups of individuals
having mean score differences on the test, such
as children from families with less education
scoring higher on a measure of conduct prob-
lems or African-American adolescents scoring
higher on a measure of extraversion. Generally,
such mean differences on tests are not consid-
ered a meaningful indicator of bias (Reynolds &
Kaiser, 1990). Instead, differential test function-
ing (DTF) is usually considered evidence for
test bias, and this refers to evidence that the
group differences in test scores result in differ-
ences in how well the test measures what it is
supposed to measure for the different groups.
Again, this can be framed in terms of differences
in the validity of how well the test measures the
Chap. 2, there are many types of validity that
can be influenced by DIF.
Content validity bias occurs when the con-
tent of a test seems inappropriate or, perhaps,
even offensive to a group of individuals. This is
usually tested by having individuals from differ-
ent groups review the items of test and judge
whether any items are inappropriate or insult-
ing. Construct validity bias exists when the
measurement of a trait differs across groups.
One of the most popular methods used to study
construct validity bias is factor analysis. For
example, one would want to test whether the
factor structure of the test of personality is
invariant (i.e., does not change) across sex, lan-
guage, race, or ethnicity. For example, van de
Looij-Jansen et al. (2011) demonstrated invari-
ance in the five-factor structure (i.e., emotional
symptoms, conduct problems, hyperactivity-­
inattention, peer problems, prosocial behavior)
72
in the Strengths and Difficulties Questionnaire
across gender, age, parental level of education,
and ethnicity in a sample of 11,881 students in
the Netherlands. Predictive-validity bias occurs
when scores on a test predict important out-
comes differently for different groups of indi-
viduals. In the example provided in which a test
showed that African-Americans scored higher
on a measure of extraversion, predictive-­validity
bias would be demonstrated if the scores on the
scale also predicted more friendships, greater
social skills, and greater positive affect for
Caucasian youth than for the African-­American
adolescents.
Cultural Competence
From this discussion of bias, it is clear that it can
occur between any groups of people, whether
they are separated by gender, educational level,
age, language, or any of a number of other char-
acteristics. One area that has been a particular
focus in clinical assessments is the potential for
bias across cultural groups. The relative impor-
tance of this form of bias is likely due to the
increased globalization of many societies, which
has resulted in much greater cultural diversity.
As a result, there have been a number of guide-
lines to help clinicians engage in culturally com-
petent and ethically sound practice. One of the
most comprehensive of these guidelines is the
Multicultural Guidelines: An Ecological
Approach to Context, Identity, and
Intersectionality published by the American
Psychological Association (APA, 2017). A sum-
mary of these guidelines and some key implica-
tions for the clinical assessment of child and
adolescent personality and behavior is provided
in Table 4.2.
Conclusions
In summary, there a number of important ethical
guidelines that can help psychologists engage in
accurate and fair clinical assessments. Both clin-
ical assessors in training, as well as experienced
4 Ethics in Testing: Rights, Responsibilities, and Fairness
assessors, should regularly review these guide-
lines and engage in discussions with colleagues
when questions come up as to how to apply them
in practice. In this chapter, we provide a brief
overview of some of the key principles that we
feel are especially important for the clinical
assessment of child and adolescent personality
and behavior. However, of even greater impor-
tance, we use these principles throughout this
text to guide our discussion of, and the recom-
mendations we provide for, all parts of the
assessment process.
Chapter Summary
1. Two important sources of ethical guidelines
for clinical assessments of children and ado-
lescents are the Ethical Principles of
Psychologists and Codes of Conduct (APA,
2016) and The Standards for Educational
and Psychological Testing (AERA, APA,
NCME, 2014).
2. Before providing any clinical service to a
child are adolescent, it is both a legal and ethi-
cal requirement to obtain informed consent
for these services.
3. A critical ethical principle is that an assessor
should only administer tests for which he or
she is competent.
4. Clinical assessors should carefully follow all
standardized procedures for administration
and avoid introducing construct-irrelevant
variance into the testing process.
5. Perhaps one of the most important ethical
principles related to clinical assessments is
that only interpretations that have been sup-
ported by research (i.e., that are evidence-­
based) should be made from test scores.
6. Clinical assessors should take reasonable
steps to discuss the results of an evaluation
with the parent and child, preferably in per-
son, and allow both the parent and child to ask
questions and fully understand the results and
their implications.
7. Clinical assessors should make accommoda-
tions in the testing procedures for children and
adolescents with disabilities that enhance the
accuracy of the test results.
Conclusions
Table 4.2 Multicultural Guidelines: An Ecological Approach to Context, Identity, and Intersectionality (APA, 2017)
Guideline
Guideline 1. Psychologists seek to recognize and
understand that identity and self-definition are
fluid and complex and that the interaction between
the two is dynamic. To this end, psychologists
appreciate that intersectionality is shaped by the
multiplicity of the individual’s social contexts
Guideline 2. Psychologists aspire to recognize and
understand that as cultural beings, they hold
attitudes and beliefs that can influence their
perceptions of and interactions with others as well
as their clinical and empirical conceptualizations.
As such, psychologists strive to move beyond
conceptualizations rooted in categorical
assumptions, biases, and/or formulations based on
limited knowledge about individuals and
communities
Guideline 3. Psychologists strive to recognize and
understand the role of language and
communication through engagement that is
sensitive to the lived experience of the individual,
couple, family, group, community, and/or
organizations with whom they interact.
Psychologists also seek to understand how they
bring their own language and communication to
these interactions
Guideline 4. Psychologists endeavor to be aware of
the role of the social and physical environment in
the lives of clients, students, research participants,
and/or consultees
Guideline 5. Psychologists aspire to recognize and
understand historical and contemporary
experiences with power, privilege, and oppression.
As such, they seek to address institutional barriers
and related inequities, disproportionalities, and
disparities of law enforcement, administration of
criminal justice, educational, mental health, and
other systems as they seek to promote justice,
human rights, and access to quality and equitable
mental and behavioral health services
Guideline 6. Psychologists seek to promote
culturally adaptive interventions and advocacy
within and across systems, including prevention,
early intervention, and recovery
Guideline 7. Psychologists endeavor to examine
the profession’s assumptions and practices within
an international context, whether domestically or
internationally based, and consider how this
globalization has an impact on the psychologist’s
self-definition, purpose, role, and function
73
Some key implications for the clinical assessment of child and
adolescent personality and behavior
Avoid overgeneralized or simplistic categories or labels of
sociocultural groups
Recognize how a person’s identity is shaped by cultural
forces
Recognize that there can be important generational
differences in cultural identity, reflected in differences
between children and their parents that could influence the
interpretation of test results
Recognize that behavior that may be normative in one
sociocultural context may be considered pathological and
maladaptive in another
Examine preexisting beliefs and assumptions about persons
from different sociocultural groups
Recognize how their and their clients’ sociocultural identities
and experiences could influence interactions during the
assessment process
Recognize the great heterogeneity within individuals in a
sociocultural group
Engage in ongoing training, education, and personal
reflection on multicultural issues
Recognize that language describing cultural identity in
conversations with diverse clients and in test reports
summarizing results of an evaluation conveys perceptions of
and feelings about a particular group
Recognize that there can great variations within cultural
groups as to the preferred terminology use to refer to their
sociocultural group
Recognize that the meaning of labels and terminology
referring to sociocultural groups can change over time
Consider the influence that resource-rich and resource-poor
environments can have on a person when interpreting test
results
Recognize the influence that the experience of disparities in
opportunities can have on a person’s psychological
functioning
Consider how experienced racism can influence a person’s
psychological functioning
Consider how experienced racism could influence a client’s
attitudes and behaviors during the assessment process
Consider the influence of acculturation (i.e., the degree of
identification with the dominant culture) when interpreting
test results
Consider how fear and distrust of institutions could influence
mental healthcare utilization
Identify and advocate for community services that are
culturally adaptive
Engage in dialog with practitioners from different countries
to enhance a global perspective
Recognize one’s own cultural and political perspectives and
avoid imposing them on clients of different nationalities
Consider the impact of mass trauma (e.g., natural disaster,
attempted genocide, economic crises) on persons’
psychological functioning
(continued)
74
Table 4.2 (continued)
Guideline
Guideline 8. Psychologists seek awareness and
understanding of how developmental stages and
life transitions intersect with the larger
biosociocultural context, how identity evolves as a
function of such intersections, and how these
different socialization and maturation experiences
influence worldview and identity
Guideline 9. Psychologists strive to conduct
culturally appropriate and informed research,
teaching, supervision, consultation, assessment,
interpretation, diagnosis, dissemination, and
evaluation of efficacy
Guideline 10. Psychologists actively strive to take
a strength-based approach when working with
individuals, families, groups, communities, and
organizations that seeks to build resilience and
decrease trauma within the sociocultural context
8. If the validity of the interpretations of a test is
not equally valid across groups, this is
­evidence of “test bias” or “measurement bias.”
4 Ethics in Testing: Rights, Responsibilities, and Fairness
Some key implications for the clinical assessment of child and
adolescent personality and behavior
Recognize that a persons’ cultural identity can change over
their life span
Consider how developmental changes in cultural identity
may be influencing the results of psychological testing
Recognize that a person’s cultural identity and its influence
on adjustment can be influenced by specific historical events
Recognize that stressors associated with cultural identity may
vary depending on the stage of development
Recognize that assessment tools often have limited validation
across diverse ethnic groups and, thus, have the potential to
mischaracterize and miss mental health needs of minority
sociocultural groups
Carefully consider whether tests that are administered are
free from measurement bias for the sociocultural group of the
person being assessed
Monitor effectiveness of services in a way that can detect
potential differences in their acceptability and efficacy across
sociocultural groups
Interpret psychological tests in light of both risk and
resilience factors that are evident in a person’s sociocultural
context
Recognize that resilience may be defined and expressed in
distinct ways across sociocultural contexts
Recognize that behavior thought to reflect resilience in one
cultural context may be considered undesirable in another
9. Cultural competence is important in order to
provide accurate and fair test results for mem-
bers of various cultural groups.