Structured and Standardized Assessments in Education

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Structured and Standardized
Assessments
 
Blake Beecher
Eastern Washington University
 
Learning Objectives:
 
1.
Increase knowledge about the role and purpose of
structured assessments
2.
Increase knowledge how to address findings of
structured assessments
3.
Become familiar with frequently used structured
assessment tools
4.
Become competent in administering, interpreting, and
scoring above assessments
5.
Demonstrate ability to administer, interpret, and utilize
an assessment in demonstration with peer
What 
is
 a standardized measure?
 
Measures designed in such a way that the questions,
conditions for administering, scoring procedures, and
interpretations are consistent and are administered and
scored in a predetermined, standard manner.
Vary in what they measure; type; perspective of user
Uniform procedures for scoring & administrating a “test”
Enough info to judge whether test is appropriate for your
situation
 
Factors in Selecting Measures
 
Easy
Quick
Not expensive
Non-offensive (non intrusive)
Supported by research
Is applicable to your setting
Gives you beneficial information
 
Purpose
 
What is the problem being measured?
Substance Abuse?
Depression?
Cognition?
How sensitive or appropriate is the measure?
 
What is the benefit of using this measure?
 
 
 
 
Interpretation
 
Clearly stated (clinical cut-offs)
Enough information
Do you understand how to use and interpret the
assessment tool?
 
Validity
 
Does the measure actually measure the presenting
issue? Does it measure what it’s supposed to?
Does the measure reflect the range of the severity
problem?
Does it increase if expected?
 
Reliability
 
How consistent, stable or dependable is the measure?
Would repeated testing yield the same result?
 
Advantages of Standardized Measures
 
Efficiency
Accessibility
Comparability
Neutrality
Evaluation friendly
 
Disadvantages
 
Psychometric problems, norms
Limits of what the test measures
Practical problems
Agency problems
Ethical problems
 
Administration
 
Ask permission
Be clear on objectives of test, how it will be used
Would you rather I read it to you?
Stress importance of accurate responses
Home, office, waiting room?
How often?
 
Common Assessments which may be
used in Integrated Healthcare
 
DSM Diagnosis
Mental Status Exam
Depression (PHQ9)
Bipolar (MDQ)
SAFE-T suicide screen
Trauma Screen (PC-PTSD)
Substance Abuse (CAGE aid)
Mini Mental State (brief cognitive screen)
Pediatric Symptom Checklist
Activities of Daily Living (Katz)
 
 
To provide clear descriptions of
diagnostic categories in order to
enable clinicians and investigator
to diagnose, communicate about,
study, and treat people with
various mental disorders
 
Diagnostic and Statistical
Manual of Mental Disorders
 
Comprehensive classification system of
medical conditions and mental disorders
Official medical and psychiatric classification of
diseases used throughout most of the world
 
International Classification of
Disease (ICD-10)
 
Both are the classification systems and fully
compatible, although the wording may differ.
 
All of the DSM-IV-TR categories are found in
ICD-10 but not all ICD categories are found in
DSM-IV.
 
ICD-10  VS  DSM-IV-TR
 
Axis I:  Psychiatric Diagnoses
Axis II: Personality Disorders
   Mental Retardation
Axis III: Medical Diagnosis
Axis IV: Psychological and Environmental Stressors
Axis V: The Global Assessment of
 
Functioning (GAF)
 
Multiaxial System
 
Anxiety Disorders
Mood Disorders
Substance-related Disorders
Schizophrenia and Other Psychotic Disorders
Delirium, Dementia, and Amnestic and other
Cognitive Disorders
Mental Disorders Due to a General Medical Condition
Eating Disorders
Adjustment Disorders
 
Axis I: Clinical Disorders
1
 
Somatoform Disorders
Factitious Disorders
Dissociative Disorders
Sexual and Gender Identity Disorders
Eating Disorders
Sleeping Disorders
Impulse-Control Disorders
Adjustment Disorders
 
Axis I: Clinical Disorders
2
 
Axis II:
Personality Disorders
3
 
Paranoid Personality Disorder
Schizoid Personality Disorder
Schizotypal Personality Disorder
Antisocial Personality Disorder
Borderline Personality Disorder
Histrionic Personality Disorder
Narcissistic Personality Disorder
Avoidant Personality Disorder
Dependent Personality Disorder
Obsessive-Compulsive Personality Disorder
Personality Disorder not Otherwise
Specified
Mental Retardation
 
Cluster A: Odd,
Eccentric
 
Cluster B: Emotional,
dramatic, erratic
 
Cluster C: Anxious,
fearful
 
Infection and parasitic disease (001-139)
Neoplasms (140-239)
Endocrine, nutritional, and metabolic
disease and immunity disorders (240-279)
Disease of the blood and blood-forming
organs (280-289)
Disease of the nervous system and sense
organs (320-389)
 
    
Source: DSM-IV, P28
 
Axis III: General Medical
Condition
 
Common Medical Conditions (Axis III) in
Integrated Healthcare
 
Obesity
Diabetes
Hypertension
Heart Disease
Arthritis
Injuries
Respiratory Diseases (many related to smoking)
 
Problems with Primary Support Group
Problems Related to the Social 
Environment
Educational Problems
Occupational Problems
Housing Problems ,  Economic Problems
Problems with Access to Health Services
Problems Related to Interaction with the
Legal System
Other Psychological and Environmental
Problems
 
Axis IV: Psychosocial and Environmental
Problems
 
Reports the clinician’s view of the client’s overall
level of functioning at the time of the interview.
Uses a global assessment of functioning scale
(GAF) that ranges from a score of 100 (high) to
1 (low).  It is reported as (e.g.) GAF=65.
 
AXIS V:
 
Global Assessment of
Functioning
 
100-91: Superior functioning, no
symptoms
90-81: Absent or minimal symptoms, good
functioning in all area
80-71: Transient and expectable reactions
to psycho social stressors
70-61: Some mild symptoms, some
difficulty in social, occupational, or school
functioning
 
Axis V: Global Assessment of
Functioning Scale
 
60-51: Moderate symptoms, moderate
difficulty in social , occupational, or
school functioning
50-41: Serious symptoms, serious
impairment in social, occupational, or
school functioning
40-31: Some impairment in reality testing
or communication or major impairment
in several areas-work, school, family
relations, judgment, thinking or mood
 
Axis V: GAF Scale
 
30-21: Behavior is considerably influenced by
delusions or hallucinations or serious impairment
in communication or judgment
20-11: Some danger of hurting self or others, or
gross impairment in communication
10-1: Persistent danger of severely hurting self or
others, or serious suicidal act with
0: Inadequate information
 
Axis V: GAF Scale
 (Cont’d)
 
Axis I: Major Depression Disorder
 
Alcohol Abuse
Axis II: No Diagnosis
Axis III: Hypertension, Diabetes
Axis IV: Social Isolation, unemployed,
housing problems,
Axis V: GAF=40 (current)
 
Multiaxial Diagnostic
Schema
 Example
 
ADDRESSING Guideline to Assess for
Client Cultural Influences
4
 
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Activity
 
Break into groups of 3 to practice one or more of the
structured instruments covered. 1 SWer, 1 client, and 1
observer.  Have the student client play the role of a
client they are familiar with. After 5-7 minute
interaction, stop, all members discuss for 2-3 minutes,
then rotate.
 
References
 
1.
American Psychiatric Association. (2000). 
Diagnostic
and statistical manual of mental disorders
 (4th ed.,
text rev.). Washington, DC: Author. (p. 26)
2.
American Psychiatric Association. (2000). 
Diagnostic
and statistical manual of mental disorders
 (4th ed.,
text rev.). Washington, DC: Author. (p. 26)
3.
American Psychiatric Association. (2000). 
Diagnostic
and statistical manual of mental disorders
 (4th ed.,
text rev.). Washington, DC: Author. (p. 27)
4.
Hays, P.A. (1996). Addressing the complexities of
culture and gender in counseling. Journal of
Counseling and Development, 74, 332-338.
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Explore the world of structured and standardized assessments with a focus on their role, purpose, and administration. Learn about important factors in selecting measures, interpreting results, and evaluating validity and reliability. Discover the benefits and advantages of standardized measures in educational settings.

  • Structured assessments
  • Standardized measures
  • Education
  • Validity
  • Reliability

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  1. Structured and Standardized Assessments Blake Beecher Eastern Washington University

  2. Learning Objectives: 1. Increase knowledge about the role and purpose of structured assessments 2. Increase knowledge how to address findings of structured assessments 3. Become familiar with frequently used structured assessment tools 4. Become competent in administering, interpreting, and scoring above assessments 5. Demonstrate ability to administer, interpret, and utilize an assessment in demonstration with peer

  3. What is a standardized measure? Measures designed in such a way that the questions, conditions for administering, scoring procedures, and interpretations are consistent and are administered and scored in a predetermined, standard manner. Vary in what they measure; type; perspective of user Uniform procedures for scoring & administrating a test Enough info to judge whether test is appropriate for your situation

  4. Factors in Selecting Measures Easy Quick Not expensive Non-offensive (non intrusive) Supported by research Is applicable to your setting Gives you beneficial information

  5. Purpose What is the problem being measured? Substance Abuse? Depression? Cognition? How sensitive or appropriate is the measure? What is the benefit of using this measure?

  6. Interpretation Clearly stated (clinical cut-offs) Enough information Do you understand how to use and interpret the assessment tool?

  7. Validity Does the measure actually measure the presenting issue? Does it measure what it s supposed to? Does the measure reflect the range of the severity problem? Does it increase if expected?

  8. Reliability How consistent, stable or dependable is the measure? Would repeated testing yield the same result?

  9. Advantages of Standardized Measures Efficiency Accessibility Comparability Neutrality Evaluation friendly

  10. Disadvantages Psychometric problems, norms Limits of what the test measures Practical problems Agency problems Ethical problems

  11. Administration Ask permission Be clear on objectives of test, how it will be used Would you rather I read it to you? Stress importance of accurate responses Home, office, waiting room? How often?

  12. Common Assessments which may be used in Integrated Healthcare DSM Diagnosis Mental Status Exam Depression (PHQ9) Bipolar (MDQ) SAFE-T suicide screen Trauma Screen (PC-PTSD) Substance Abuse (CAGE aid) Mini Mental State (brief cognitive screen) Pediatric Symptom Checklist Activities of Daily Living (Katz)

  13. Diagnostic and Statistical Manual of Mental Disorders To provide clear descriptions of diagnostic categories in order to enable clinicians and investigator to diagnose, communicate about, study, and treat people with various mental disorders

  14. International Classification of Disease (ICD-10) Comprehensive classification system of medical conditions and mental disorders Official medical and psychiatric classification of diseases used throughout most of the world

  15. ICD-10 VS DSM-IV-TR Both are the classification systems and fully compatible, although the wording may differ. All of the DSM-IV-TR categories are found in ICD-10 but not all ICD categories are found in DSM-IV.

  16. Multiaxial System Axis I: Psychiatric Diagnoses Axis II: Personality Disorders Mental Retardation Axis III: Medical Diagnosis Axis IV: Psychological and Environmental Stressors Axis V: The Global Assessment of Functioning (GAF)

  17. Axis I: Clinical Disorders1 Anxiety Disorders Mood Disorders Substance-related Disorders Schizophrenia and Other Psychotic Disorders Delirium, Dementia, and Amnestic and other Cognitive Disorders Mental Disorders Due to a General Medical Condition Eating Disorders Adjustment Disorders

  18. Axis I: Clinical Disorders2 Somatoform Disorders Factitious Disorders Dissociative Disorders Sexual and Gender Identity Disorders Eating Disorders Sleeping Disorders Impulse-Control Disorders Adjustment Disorders

  19. Axis II: Personality Disorders3 Paranoid Personality Disorder Schizoid Personality Disorder Schizotypal Personality Disorder Antisocial Personality Disorder Borderline Personality Disorder Histrionic Personality Disorder Narcissistic Personality Disorder Avoidant Personality Disorder Dependent Personality Disorder Obsessive-Compulsive Personality Disorder Personality Disorder not Otherwise Specified Mental Retardation Cluster A: Odd, Eccentric Cluster B: Emotional, dramatic, erratic Cluster C: Anxious, fearful

  20. Axis III: General Medical Condition Infection and parasitic disease (001-139) Neoplasms (140-239) Endocrine, nutritional, and metabolic disease and immunity disorders (240-279) Disease of the blood and blood-forming organs (280-289) Disease of the nervous system and sense organs (320-389) Source: DSM-IV, P28

  21. Common Medical Conditions (Axis III) in Integrated Healthcare Obesity Diabetes Hypertension Heart Disease Arthritis Injuries Respiratory Diseases (many related to smoking)

  22. Axis IV: Psychosocial and Environmental Problems Problems with Primary Support Group Problems Related to the Social Environment Educational Problems Occupational Problems Housing Problems , Economic Problems Problems with Access to Health Services Problems Related to Interaction with the Legal System Other Psychological and Environmental Problems

  23. AXIS V: Global Assessment of Functioning Reports the clinician s view of the client s overall level of functioning at the time of the interview. Uses a global assessment of functioning scale (GAF) that ranges from a score of 100 (high) to 1 (low). It is reported as (e.g.) GAF=65.

  24. Axis V: Global Assessment of Functioning Scale 100-91: Superior functioning, no symptoms 90-81: Absent or minimal symptoms, good functioning in all area 80-71: Transient and expectable reactions to psycho social stressors 70-61: Some mild symptoms, some difficulty in social, occupational, or school functioning

  25. Axis V: GAF Scale 60-51: Moderate symptoms, moderate difficulty in social , occupational, or school functioning 50-41: Serious symptoms, serious impairment in social, occupational, or school functioning 40-31: Some impairment in reality testing or communication or major impairment in several areas-work, school, family relations, judgment, thinking or mood

  26. Axis V: GAF Scale (Contd) 30-21: Behavior is considerably influenced by delusions or hallucinations or serious impairment in communication or judgment 20-11: Some danger of hurting self or others, or gross impairment in communication 10-1: Persistent danger of severely hurting self or others, or serious suicidal act with 0: Inadequate information

  27. Multiaxial Diagnostic Schema Example Axis I: Major Depression Disorder Alcohol Abuse Axis II: No Diagnosis Axis III: Hypertension, Diabetes Axis IV: Social Isolation, unemployed, housing problems, Axis V: GAF=40 (current)

  28. ADDRESSING Guideline to Assess for Client Cultural Influences4 A ge and generational influences D isability status (developmental disability) D isability status (acquired physical/ cognitive/psychological disabilities) R eligion and spiritual orientation E thnicity S ocioeconomic status S exual orientation I ndigenous heritage N ational origin G ender

  29. Activity Break into groups of 3 to practice one or more of the structured instruments covered. 1 SWer, 1 client, and 1 observer. Have the student client play the role of a client they are familiar with. After 5-7 minute interaction, stop, all members discuss for 2-3 minutes, then rotate.

  30. References 1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author. (p. 26) 2. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author. (p. 26) 3. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author. (p. 27) 4. Hays, P.A. (1996). Addressing the complexities of culture and gender in counseling. Journal of Counseling and Development, 74, 332-338.

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