Psychologists have recognized for decades that psychological tests will only remain valid if test materials remain secure; that is, only accessible to, and available for use by, psychologists proficient in psychological and/or neuropsychological testing. This imperative applies to the use of empirical instruments in both clinical and forensic assessments. However, threats to test security are most severe in the context of forensic evaluations, where attorneys aggressively seek release of protected test materials. Although threats to test security have the potential to affect specialists in all of psychology’s specialties, by far the greatest attention and energetic defense of protected test information has come from within Clinical Neuropsychology (CN), and, in particular, from within the de facto subspecialty of Forensic Neuropsychology (FN). This likely reflects the fact that neuropsychologists routinely administer psychological and cognitive tests to clinical and forensic examinees, as a central means of arriving at empirically-based diagnostic conclusions and recommendations. If examinees are exposed to test materials prior to testing, the reliability and validity of the results cannot be assumed and conclusions based upon those results may be inaccurate. The risk posed by the possibility of relying upon invalid test data led CN and FN practitioners, as well as forensic psychology practitioners, to develop a wide range of procedures to assess the nature of examinees’ responses, known as performance validity tests (PVTs) and symptom validity tests (SVTs), which are widely accepted and used (Sweet et al., 2021) throughout the United States and Canada.
As noted in the Official Position of the American Academy of Clinical Neuropsychology (AACN) on test security (Boone et al., 2022), to ensure a level playing field across clinical and forensic evaluations:
… no individual should have gained access to item content or test-taking strategy that would allow unfair advantage, whether that advantage be manipulating results to artificially increase or decrease performance capabilities or to misrepresent symptom report. In this context, test security refers to the broad and clear expectation that in order to maintain valid use and effectiveness, the contents and key operational characteristics of psychological and neuropsychological tests must be protected from inappropriate disclosure to non-psychologists. (p.524)
Test security involves protection of test materials from release to non-psychologists, which would include actual tests and test manuals, as well as test data forms showing questions and answers, live third-party observation of testing, or audio or video recording of testing. The AACN test security position paper outlines a number of negative effects that can occur if test security is not ensured:
- Damage to test effectiveness
- Inaccurate conclusions may be inappropriately applied to clinical, educational, and forensic examinees. Iatrogenesis, failure to provide appropriate treatment, and wasting of finite societal resources may occur.
- Years of test development costs and professional time investment are lost.
- Detriment to society
- Impact to public safety (e.g., test results on pilots and police officer candidates may not accurately represent critical skills and characteristics).
- Impact to judicial decisions (e.g., judges and juries relying on psychological and neuropsychological test data may be misinformed, leading to erroneous decisions).
- Impact to the educational system (e.g., psychometric results used to document presence or absence of salient learning disorders, and to establish legitimate need for academic accommodations, may be inaccurate).
- Impact to the medical care system (e.g., patients can learn to ‘game’ the system to obtain medications, such as stimulants and opiates).
- Impact to public and private services and resources (e.g., feigning of conditions may result in unjustified disability status and compensation).
- Coaching of examinees by attorneys
- Multiple surveys have clearly identified attorney willingness to coach clients in advance of psychological and neuropsychological testing (e.g., Spengler, 2020; see also discussion in Boone et al., 2022).
We are aware that some of our specialist colleagues take the position that all test materials, including questions, answers, manuals, and interpretive guidelines, must be released to attorneys to ensure a “level playing field” (i.e., adequate cross examination). We believe this position to be based upon a false premise and note that this proposition was evaluated in an Interorganizational Practice Committee* (IOPC) position statement (Boone et al., 2024; see Footnote) that deconstructs this notion. In fact, when attorneys attempt to serve as “proxy” experts in analyzing psychological test information for the purpose of cross-examining expert psychology and neuropsychology witnesses, there is a substantial risk of misinformation being presented to the finder of fact. Those with expertise in the technical aspects and salient interpretive findings of psychological and neuropsychological testing are competent to identify and present reliable and valid information to legal decision makers. As stated in Boone et al. (2024), “Simply put, attorneys have no formal training or expertise in analyzing test data, and therefore need to retain experts for that purpose.” Moreover, when the role of test security relates to tests designed to ensure the integrity of examinations that directly affect attorneys, legal professionals reach the conclusion that test security is paramount. As noted in Boone et al. (2022), when the National Conference of Bar Examiners (NCBE) and members of organizations that protect the Law School Admission Test (LSAT) and other national tests conducted a joint test security conference, they concluded that “the importance of maintaining test based on those scores cannot be overemphasized, because cheating, regardless of which form it takes, erodes the validity of the interpretations of test scores and then undermines the legitimacy of decisions.” Congruent with the perspective that cheating should be disallowed, with the same purpose in mind, select state laws specifically establish that psychological test materials are not to be disclosed in any type of administrative or judicial proceeding, typically with the directive that, as necessary, these materials should be shared only between licensed psychologists.
A typical overture intended to placate experts reluctant to share test materials with attorneys or allow third party observation or recording of evaluations is issuance of a judicial protective order that limits disclosure and future use of discovery materials. However, the IOPC, in a recent position paper (Boone et al. in press), described protective orders as illusory safeguards, rather than viable solutions, and identified eight bases in support of the conclusion that protective orders offer insufficient protection:
- Protective orders are not viable in the digital age given that digitization provides the ability to rapidly upload, archive, and distribute protected test materials in the absence of any meaningful oversight.
- When protected test information is released to attorneys under protective order in litigated cases, the “fox is guarding the hen house,” in that attorneys can benefit financially if they are able to access test materials and coach clients as to how to manipulate test performance.
- When a protective order breach occurs, psychological and neuropsychological tests are more vulnerable to damage than other “trade secrets” because future use is compromised.
- Protective orders are not adequately enforceable or enforced.
- Protective orders may be challenged long after the case at issue has been concluded.
- The sheer number of requested protective orders at the current time exponentially increases the likelihood of breaches of protected test information.
- Access to protected test information under protective order extends well beyond attorneys.
- Sanctions for protective order breaches are rare, typically minor, and therefore not adequately deterrent
Key to judicial decisions related to the necessity for protection of psychological and neuropsychological test materials is evidence of the consensus among psychology practitioners against test disclosure to non-psychologists. To this end, the IOPC conducted a 2023 national survey of psychologists, who were primarily neuropsychologists and whose practices included clinical or forensic assessment (Beattey et al., under review). The opinions expressed by the 628 licensed respondents strongly favored keeping test materials secure:
The vast majority of the surveyed group of more than 600 neuropsychologists and psychologists would not voluntarily provide raw test data directly to an attorney, if not compelled by the courts to do so, would not voluntarily provide copies of actual test materials directly to an attorney, if not compelled by the courts to do so, and do not believe that release of test materials to an attorney under a protective order issued by the court is adequately protective of test security. It is rare in surveys of professionals to find this much unanimity of opinion, but not unexpected if one considers the importance of the topic, which is no less than securing the validity of the assessment practices of neuropsychologists and psychologists.
Summary
As expressed in this brief communication to our ABPP colleagues, all specialists whose practices include psychological or neuropsychological testing share the same obligation to maintain test security, whether regarding test materials or third-party observation (including live observers, audio recording, and video recording). Attorneys have no obligation to protect the scientific validity of empirical assessment measures and do not share the ethical imperatives of psychologists, or the intellectual property interests of test publishers, related to test security. Moreover, protective orders do not offer adequate protection for psychological and neuropsychological tests. Instead, it is incumbent upon psychologists to promote test security, transparency, and impartiality in legal proceedings, by sharing essential protected test information solely with other psychology experts, who are the only professionals capable of appropriately critiquing psychological and neuropsychological work products. Within the neuropsychological community there is strong agreement regarding the necessity of withholding protected test information from non-psychologists.
Table 1 provides a chronological listing of relevant North American position papers that provide guidance to psychology practitioners regarding concrete steps that promote test security. We have also identified many additional US and international publications—an exhaustive listing of which is beyond the scope of this brief communication—which address the importance of maintaining the security of psychological and neuropsychological test information. These include peer-reviewed papers that represent expert author viewpoints, rather than position papers by organizations (e.g., Butz, English, Meyers, & Cohen, 2023; Lavigne, Rios, & Davis, 2024; Marcopulos, Kaufmann, & Patel, 2024), book chapters (e.g., Sweet & Klipfel, 2022), and an international paper that addresses access to test protocols (Diagnostik- und Testkuratorium der Föderation Deutscher Psychologenvereinigungen, 2021).
Footnote: The Inter-Organizational Practice Committee consists of representatives from major national neuropsychology practice organizations: American Academy of Clinical Neuropsychology, American Board of Professional Neuropsychology, National Academy of Neuropsychology, Society of Clinical Neuropsychology (Division 40, American Psychological Association), and the Cultural Neuropsychology Council.
References
Beattey Jr, R.A., Bender, H.A., Silva, D.M., Boone, K.B., & Kaufmann, P.M., & Sweet, J.J. (under review). Survey of test security practices and perspectives of licensed psychologists.
Boone, K. B., Kaufmann, P. M., Sweet, J. J., Leatherberry, D., Beattey, R. A., Silva, D., Victor, T.L., Boone, R.P., Spector, J., Hebben, N., Hanks, R.A., & James, J. (2024). Attorney demands for protected psychological test information: Is access necessary for cross examination or does it lead to misinformation? An Interorganizational Practice Committee position paper. The Clinical Neuropsychologist, 38(4), 889–906. https://doi.org/10.1080/13854046.2024.2323222
Boone, K.B., Sweet, J.J., Beattey, Jr., R.A., Kaufmann, P.M., Hebben, N., Marriero, C., James, J., Silva, D., Victor, T., Hamilton, A., Glen, T., Kinsora, T.F., Bender, H.A., Barisa, M. (in press). Release of protected test information under protective order: Viable solution or illusory safeguard? An Interorganizational Practice Committee position paper. Archives of Clinical Neuropsychology.
Boone, K.B., Sweet, J.J., Byrd, D.A., Denney, R.L., Hanks, R.A., Kaufmann, P.M., Kirkwood, M.W., Larrabee, G.J., J.Y., Marcopulos, B.A., Morgan, J.E., Paltzer, Rivera Mindt, M., Schroeder, R.W., Sim, A.H., & Suhr, J.A. (2022) Official position of the American Academy of Clinical Neuropsychology on test security, The Clinical Neuropsychologist, 36:3, 523-545. https://doi.org/10.1080/13854046.2021.2022214
Bütz, M. R., English, J. V., Meyers, J. E., & Cohen, L. J. (2023). Threats to the integrity of psychological assessment: The misuse of test raw data and materials. Applied Neuropsychology: Adult, 1-20. https://doi.org/10.1080/23279095.2023.2241094
Kaufmann, P. M. (2005). Protecting the objectivity, fairness, and integrity of neuropsychological evaluations in litigation. A privilege second to none? The Journal of Legal Medicine, 26(1), 95–131. https://doi.org/10.1080/01947640590918007
Kaufmann, P. M. (2009). Protecting raw data and psychological tests from wrongful disclosure: A primer on the law and other persuasive strategies. The Clinical Neuropsychologist, 23(7), 1130–1159. https://doi.org/10.1080/13854040903107809
Lavigne, S., Rios, A., & Davis, J. J. (2024). Does generative artificial intelligence pose a risk to performance validity test security? The Clinical Neuropsychologist. https://doi.org/10.1080/13854046.2024.2379023
Marcopulos, B. A., Kaufmann, P., & Patel, A. C. (2024). Forensic neuropsychological assessment. Behavioral Sciences & the Law, 42(4), 265–277. https://doi.org/10.1002/bsl.2656
Spengler, P. M., Walters, N. T., Bryan, E., & Millspaugh, B. S. (2020). Attorneys’ attitudes toward coaching forensic clients on the MMPI-2: Replication and extension of attorney survey by Wetter and Corrigan (1995). Journal of Personality Assessment, 102(1), 56–65. https://doi.org/10.1080/00223891.2018.1501568
Sweet, J. J., Heilbronner, R. L., Morgan, J. E., Larrabee, G. J., Rohling, M. L., Boone, K. B., Kirkwood, M. W., Schroeder, R. W., Suhr, J. A., & Conference Participants (2021). American Academy of Clinical Neuropsychology (AACN) 2021 consensus statement on validity assessment: Update of the 2009 AACN consensus conference statement on neuropsychological assessment of effort, response bias, and malingering. The Clinical Neuropsychologist, 35, 1053-1106. https://doi.org/10.1080/13854046.2021.1896036
Sweet, J.J., & Klipfel, K. M. (2022). Forensic primer for the non-forensic neuropsychologist: When clinicians participate in forensic proceedings. In R. Schroeder & P. Martin (Eds.), Validity assessment in clinical neuropsychological practice: Evaluating and managing noncredible performance. New York, NY: Guilford.
Sweet, J. J., Klipfel, K. M., Nelson, N. W., & Moberg, P. J. (2021). Professional practices, beliefs, and incomes of U.S. neuropsychologists: The AACN, NAN, SCN 2020 practice and ‘Salary Survey.’ The Clinical Neuropsychologist, 35, 7-80, https://doi.org/10.1080/13854046.2020.1849803
Table 1
North American Position Papers Offering Guidance on Test Security (Listed in Chronological Sequence):
American Psychological Association, APA Committee on Psychological Tests and Assessment (1994). Statement on the use of secure psychological tests in the education of graduate and undergraduate psychology students. https://www.apa.org/science/programs/testing/test-security
NAN Policy and Planning Committee (2000a). Test Security: Official position statement of the National Academy of Neuropsychology. Archives of Clinical Neuropsychology, 15, 383–386. https://psycnet.apa.org/doi/10.1093/arclin/15.5.383
NAN Policy and Planning Committee. (2000b). Presence of third party observers during neuropsychological testing: Official statement of the National Academy of Neuropsychology. Archives of Clinical Neuropsychology, 15, 379–380. https://psycnet.apa.org/doi/10.1093/arclin/15.5.379
American Academy of Clinical Neuropsychology. (2001). Policy statement on the presence of third party observers in neuropsychological assessments. The Clinical Neuropsychologist, 15, 433–439. https://doi.org/10.1076/clin.15.4.433.1888
NAN Policy and Planning Committee (2003). Test security: An update. Official statement of the National Academy of Neuropsychology. http://nanonline.org/docs/PAIC/PDFs/NANTestSecurityupdate.pdf
Attix, D. K., Donders, J., Johnson-Greene, D., Grote, C. L., Harris, J. G., & Bauer, R. M. (2007). Disclosure of neuropsychological test data: Official Position of Division 40 (Clinical Neuropsychology) of the American Psychological Association, Association of Postdoctoral Programs in Clinical Neuropsychology, and American Academy of Clinical Neuropsychology. The Clinical Neuropsychologist, 21(2), 232–238. https://doi.org/10.1080/13854040601042928
Board of Directors. (2007). American Academy of Clinical Neuropsychology (AACN) practice guidelines for neuropsychological assessment and consultation. The Clinical Neuropsychologist, 21(2), 209–231. https://doi.org/10.1080/13825580601025932
Heilbronner, R. L., Sweet, J. J., Morgan, J. E., Larrabee, G. J., & Millis, S. R. (2009). Conference participants. American Academy of Clinical Neuropsychology Consensus Conference Statement on the neuropsychological assessment of effort, response bias, and malingering. The Clinical Neuropsychologist, 23(7), 1093–1129. https://doi.org/10.1080/13854040903155063
Canadian Psychological Association. (2009). The presence of involved third party observer in neuropsychological assessments. Retrieved from https://cpa.ca/aboutcpa/policystatements/#Thirdparty
International Test Commission (July 6, 2014). The ITC Guidelines on the Security of Tests, Examinations, and Other Assessments. https://www.intestcom.org/files/guideline_test_security.pdf
American Educational Research Association, American Psychological Association, and National Council on Measurement in Education. (2014). Standards for educational and psychological testing. Washington, DC: American Psychological Association. https://www.testingstandards.net/open-access-files.html
American Psychological Association, APA Committee on Legal Issues (2016). Strategies for private practitioners coping with subpoenas or compelled testimony for client/patient records or test data or materials. Professional Psychology: Research and Practice, 47, 1–11. https://psycnet.apa.org/doi/10.1037/pro0000063
Lewandowski, A., Baker, W. J., Sewick, B., Knippa, J., Axelrod, B., & McCaffrey, R. J. (2016). Policy Statement of the American Board of Professional Neuropsychology regarding third party observation and the recording of psychological test administration in neuropsychological evaluations. Applied Neuropsychology: Adult, 23(6), 391–398. https://doi.org/10.1080/23279095.2016.1176366
International Test Commission (ITC). (2016). The international test commission guidelines on the security of tests, examinations, and other assessments. International Journal of Testing, 16(3), 181–204. https://doi.org/10.1080/15305058.20 15.1111221
Boone, K. B., Sweet, J. J., Byrd, D. A., Denney, R. L., Hanks, R. A., Kaufmann, P. M., Kirkwood, M. W., Larrabee, G. J., Marcopulos, B. A., Morgan, J. E., Paltzer, J. Y., Rivera Mindt, M., Schroeder, R. W., Sim, A. H., & Suhr, J. A. (2022). Official position of the American Academy of Clinical Neuropsychology on test security. The Clinical Neuropsychologist, 36(3), 523–545. https://doi.org/10.1080/13854046.2021.2022214
Sweet, J. J., Heilbronner, R. L., Morgan, J. E., Larrabee, G. J., Rohling, M. L., Boone, K. B., Kirkwood, M. W., Schroeder, R. W., & Suhr, J. A, & Conference Participants. (2021). American Academy of Clinical Neuropsychology (AACN) 2021 Consensus Statement on Validity Assessment: Update of the 2009 AACN Consensus Conference Statement on Neuropsychological Assessment of Effort, Response Bias, and Malingering. The Clinical Neuropsychologist, 35(6), 1053–1106. https://doi.org/10.1080/13854046.2021.1896036
Glen, T., Barisa, M., Ready, R., Peck, E., & Spencer, T. R. (2021). Update on third party observers in neuropsychological evaluation: An interorganizational position paper. The Clinical Neuropsychologist, 35, 1107–1116. https://doi.org/10.1080/13854046.2021.1901992
Western Psychological Services (WPS), aka Manson Western, Inc. (2022). WPS Test Security Position Statement. https://ecom-cdn.wpspublish.com/prod/media/content-wps/WPS-Position-Statement-re-Test%20Security-2022-11-04-DSHsigned.pdf
American Psychological Association, Committee on Psychological Tests and Assessment (2022). Statement on third party observers in psychological testing and assessment: An updated framework for decision making. https://www.apa.org/science/programs/testing/third-party-observers.pdf
Boone, K.B., Kaufmann, P.M., Sweet, J.J., Leatherberry, D., Beattey, R.A., Silva, D., Victor, T., Boone, R., Spector, J., Hebben, N., & Hanks, R.A., & James, J. (2024). Attorney demands for protected psychological test information: Is access necessary for cross examination or does it lead to misinformation? An interorganizational position paper. The Clinical Neuropsychologist, 38 (4), 889-906. https://doi.org/10.1080/13854046.2024.2323222
Boone, K.B., Sweet, J.J., Beattey, R.A., Kaufmann, P.M., Hebben, N., Marriero, C., James, J., Silva, D., Victor, T., Hamilton, A., Glen, T., Kinsora, T.F., Bender, H.A., & Barisa, M. (in press). Release of protected test information under protective order: Viable solution or illusory safeguard? An interorganizational position paper. Archives of Clinical Neuropsychology.
Jerry J. Sweet, PhD, ABPP
Board Certified in Clinical Neuropsychology and Clinical Psychology
Correspondence: jerrysweet121@gmail.com
Kyle Brauer Boone, PhD, ABPP
Board Certified in Clinical Neuropsychology
Correspondence: kboone@kyleboonephd.com
Robert A. Beattey, JD, PhD, ABPP
Board Certified in Forensic Psychology
Correspondence: rb1@beattey.org