A NEW THEORY-BASED APPROACH TO PROFILE INTERPRETATION in .NET

Drawer ANSI/AIM Code 128 in .NET A NEW THEORY-BASED APPROACH TO PROFILE INTERPRETATION
APPENDIX D
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A NEW THEORY-BASED APPROACH TO PROFILE INTERPRETATION
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and informal data. Therefore, rather than using kappa to examine the stability of categories over time, which does not adequately capture the decision-making process that underlies Kaufman and Lichtenberger s method, Watkins and Canivez should have examined the inter-rater reliability of clinicians trained in the Kaufman and Lichtenberger method to determine agreement with regard to interpretation of areas of integrity and deficit at time 1 and then again at time 2 that is, different clinicians rating the same person s areas of integrity and deficit at time 1 and then again at time 2 using the Kaufman and Lichtenberger method of intra-individual analysis. Consider the following example: A scaled score of 5 on Block Design (for example) at Time 1 emerges as a weakness based on ipsative analysis. At Time 2, Block Design yields a scaled score of 6 and is no longer considered a weakness based on ipsative analysis. A well-trained clinician would conclude that the ability underlying Block Design is deficient, regardless of a nonsignificant finding based on ipsative analysis at Time 2. This example demonstrates that an evaluation of the reliability of the Kaufman-Lichtenberger method must focus on the conclusions that clinicians who are trained in their method draw from the data. There are two other methodological issues with the Watkins and Canivez (2004) study that require mention. First, quite obviously, there will be statistical regression to the mean for all shared abilities identified on the initial test as strengths or weaknesses. For any child with an identified strength, that strength will regress toward the mean, as will any identified weakness. Of course, positive chance errors contribute to any area of ability that is identified as a strength, and negative chance errors contribute to any area of ability that is identified as a weakness. That is built into the method. It is not only because of sound clinical practice that we tell examiners to cross-validate each possible strength and weakness with clinical behaviors and other data; it is also to help ensure that the putative strengths and weaknesses are not just a function
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of the chance error. The authors did not account for predictable regression effects in their analyses, which would lower the kappas. In contrast, intelligent application of our clinical method will help control for chance. The second additional methodological issue is that Watkins and Canivez have taken a continuous variable (deviation from the mean) and turned it into a categorical variable (strength, weakness, neither). Apparently, they were trying to mimic clinical practice. However, empirical analysis and clinical practice are not synonymous. By taking a continuous variable and turning it into a categorical variable, Watkins and Canivez effectively reduced the statistical power of their analysis thereby reducing the kappa (Cohen, 1983). Thus, Watkins and Canivez s chances of finding a lack of agreement in classifications over time were maximized.
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OVERVIEW OF CRITICISMS OF THE WATKINS AND CANIVEZ (2004) STUDY
In short, a great deal happens in three years the effects of intervention, developmental changes, regression to the mean, and changes in what some subtests measure at different ages. The group data provided by Watkins and Canivez do not have implications for the individual method of profile interpretation that we advocate. The strengths and weaknesses that we believe might have useful applications for developing educational interventions are based on cognitive functioning at a particular point in time. They need to be cross-validated at that time to verify that any supposed cognitive strengths or weaknesses are consistent with the wealth of observational, referral, background, and other test data that are available for each child who is evaluated. Only then will those data-based findings inform diagnosis and be applied to help the child.
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