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Issues in Cross-Cultural Psychological Assessment by tzv97744

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									           Issues in
  Cross-Cultural Psychological
         Assessment:
Enhancing practice with migrants, refugees & indigenous
                        peoples
A conference for psychologists and other professionals practicing
  in mental health, education and neuropsychological settings


                    Program and Abstracts
                            Friday 16th May, 2008
                            9.00 a.m. - 5.00 p.m.



                                    Convened by
         The Victorian Transcultural Psychiatry Unit




    Supported by:                                         The APS College of Clinical
                                                             Neuropsychologists



              Venue: Aikenhead Building, St Vincent’s Hospital, Melbourne
                           Speakers’ biographies

                              In order of the program

Dr Ida Kaplan: Keynote speaker
                  Dr Ida Kaplan is a Clinical Psychologist and Manager of Client
                  Services at the Victorian Foundation for Survivors of Torture. She is
                  involved in the ongoing development of direct service programs and
                  training which she has conducted at national and international
                  levels. Her interests are in the intersection of mental health,
                  education and human rights issues in understanding the recovery
                  from trauma associated with the refugee experience, and in
improving assessment processes and services for refugees.

Dr Alan Tucker
Dr Alan Tucker has over 25 years experience in the practice, research and training
aspects of clinical neuropsychology. He spent most of the 1980s at the Royal
Children’s Hospital, Melbourne where he was the first Coordinator of Neuropsychology
Services, followed by a period as inaugural Chief Psychologist and Director of the
paediatric rehabilitation unit at the Victorian Rehabilitation Centre (Glen Waverly).
For the last 15 years he has been Convenor/Coordinator of the Master of Psychology/
Doctor of Psychology (Clinical Neuropsychology) program at Victoria University in
Melbourne. He was also the Foundation Chair of the National Executive of the College
of Clinical Neuropsychologists of the Australian Psychological Society (APS) in the
period 1983-5.

Dr Areti Plitas
Dr Areti Plitas has completed undergraduate degrees in psychology and
psychophysiology at Swinburne University. She also completed a Doctor of Psychology
(in clinical neuropsychology) degree at Victoria University in 2007. Her doctoral thesis
investigated the cognitive performance of healthy community dwelling Greek
Australian elderly on tests of cognitive functioning and screening tests of dementia.
Doctoral thesis findings have been presented at national and international
conferences. Areti's research interests include neuropsychological assessment and
diagnostic issues of culturally and linguistically diverse individuals (CALDI), and needs
of CALDI with dementia in aged care. She has worked as a clinical neuropsychologist
within Eastern Health for the last five years. Caseload has comprised mainly of
diagnostic assessments of older adults, and decision making capacity assessments.

Dr Ken Rowe: Keynote speaker
                  Dr Ken Rowe is the Research Director of the Learning Processes
                  research program at the Australian Council for Educational Research.
                  Dr Rowe’s post-graduate training in research, educational
                  psychology, assessment, psychometrics, and advanced statistical
                  modelling, was undertaken at the University of London, and his PhD
                  at the University of Melbourne. Dr Rowe’s research interests include:
                  ‘authentic’ educational and psychological assessment, particularly
related to evidence-based links between education and health; the impact of
externalising behaviour problems on students’ learning outcomes; and the educational/
epidemiological implications of Attention-Deficit/Hyperactivity Disorder (AD/HD) and
Chronic Fatigue Syndrome (CFS) in children and adolescents. Ken and his consultant
paediatrician wife, Dr Kathy Rowe, have expertise and experience in identifying the


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educational needs of ‘at-risk’ students and in building teacher capacities to improve
the learning outcomes of all students, including those experiencing learning
difficulties. Dr Rowe is also involved in a consultative capacity in local and
international work in assessment and reporting.

Freda Vrantsidis
Freda Vrantsidis is a research officer at the National Ageing Research Institute (NARI).
She has been at NARI for 10 years, working on a wide range of projects. Many of her
projects have related to falls prevention and physical activity for older people, and she
has been involved in a number of assessment and evaluation/validation studies. Freda
has worked with a wide range of health professionals in hospital, residential and
community settings, and with older people from various CALD backgrounds and groups
representing older people. Although she has a personal interest in the area of
dementia and carer issues, the evaluation of the Rowland Universal Dementia
Assessment Scale (RUDAS) was her first major project in the area of dementia
research.

Dr Dina LoGiudice
Dr Dina LoGiudice is a Consultant Physician in Aged Care, completing a PhD thesis
entitled “The Assessment of Services for Elderly People with Dementia”, which was
completed in 1998. This research was based at the National Ageing Research Institute
(NARI), Melbourne, at which she currently holds a position as Senior Associate. She is
currently Director of the Cognitive Dementia and Memory Service and Consultant for
the Complex Secure GEM ward (management of moderately severe people with
dementia) based at Royal Park Campus, Royal Melbourne Hospital. Dr LoGiudice was
primarily involved in the development of a culturally specific cognitive tool for
Aboriginal elders living in remote and rural areas of Western Australia and recently
completed a prevalence study of dementia and other health conditions in this
population, funded by NHMRC. Further funding is available for determining unmet
needs of Aboriginal elders in Western Australia. She is involved in various government
projects addressing the needs of those with dementia. Dr LoGiudice’s main research
interests consider the cross cultural clinical aspects of assessment and management of
people with dementia and their families.

Dr Tracy Westerman: Keynote speaker
                      Dr. Westerman is of the Nyamal people in the far North West of
                     Western Australia and is the founding Managing Director of
                     Indigenous Psychological Services (IPS). She developed IPS to
                     address the inequities that exist between the rates of mental
                     illness in Indigenous populations and the levels of access to
                     appropriate services. Dr Westerman is the only Aboriginal person in
                     Australia to have earned a PhD in Clinical Psychology. Her PhD
thesis received the Vice Chancellor’s Award for the top 10% of PhDs submitted. She has
presented numerous keynotes throughout Australia and internationally; and developed
and implemented indigenous specific training and intervention programs throughout
Australia focusing on suicide prevention, depression and trauma management. In 2005
the Canadian Government sent a delegation of Inuit researchers to Western Australia to
learn from the experience of Dr Westerman in Indigenous suicide prevention. She has
also conducted numerous national tenders and research projects into mental health
service delivery specific to Indigenous people.
      In 2007 Dr Westerman appeared in the Who’s Who of Australian Women. In 2006,
she was awarded the Suicide Prevention Australia LiFE award for contributions to
suicide prevention in Indigenous Health. Dr Westerman currently holds an NHMRC Post


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Doctoral Research Fellowship (2003-2006) to investigate Attention Deficit Hyperactivity
Disorder in Aboriginal populations. She is the first Aboriginal person to receive such a
Fellowship. Other awards include Scholarships with the Australian International
Development Assistance Bureau, Graduate Scholarship, and 1990–1992, the Department
for Community Development Scholarship 1995 – 1997, Curtin University Mark Liveris
Seminar, School of Health Sciences, PhD presentations, Winner of Certificate of
Excellence for Best oral presentation for PhD research.

Nicole Fraine
Nicole Fraine has a Masters of Clinical Psychology and a Diploma of Education. She has
worked as a Guidance Counsellor for Brisbane Catholic Education in Queensland for the
past 12 years. In her role, she is responsible to four primary schools, catering for
approximately 1000 students. She is involved in counselling, assessment and
consultation work for children with identified needs, as well as implementing and
assisting with a variety of primary and secondary prevention activities that aim to
benefit all students. In 2005, gaps were identified in the provision of Guidance
Services for refugee students in the Brisbane Archdiocese. One of the findings was that
Guidance Counsellors and Psychologists in general did not seem to have a good working
model for assessing refugee students who may be eligible for special needs services.
Nicole began to work on a document to support refugees in Brisbane Catholic
Education Schools with Rossana McDade in her role as ESL Education Officer. Nicole’s
presentation is based upon this collaborative work that began in 2005 and continues
today.

Susan Whitelaw
Susan Whitelaw has been employed by the Department of Education and Early
Childhood Development (DEECD) for nearly 30 years, firstly as a teacher and then as a
psychologist. Since 1993 she has worked as a psychologist in schools in the Dandenong
area. This area has become home for many people newly arrived from war-torn
countries, so Sue has had the opportunity to work with, and to assess, a number of
children from refugee backgrounds. Susan is aware that refugee children have many
special needs, both educational and emotional and that the school system does not
always make life easy for these children. Many schools in Dandenong have radically
changed their organisation and curriculum to cater for the needs of the refugee
community, but much more still needs to be done. Susan is particularly concerned
about the way in which refugee students’ intellectual capacity is currently assessed
and has been active in trying to bring about changes in DEECD policy in relation to
these assessments. Currently she is involved in working with a group from the APS who
hope to approach DEECD about these issues.

Frederick Wright
Fred has been a practicing psychologist for 10 years, with a Masters in Educational
Psychology, and is currently completing a Doctorate in Education, researching
metacognition across cultures and the application of a dynamic assessment approach
with people of non-English speaking backgrounds. As a psychologist Fred has worked in
city and rural areas, running programs for students “at risk” of dropping out of the
educational system and providing counselling and assessment services for students of
various cultural backgrounds. He is currently employed at Holmesglen Institute of
TAFE, which has a large population of international students and people of non-English
speaking backgrounds doing a variety of courses. A part of his job is to assess the
educational needs of students of all backgrounds who have difficulties with their
learning.




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                                   Abstracts


                             In order of the program


       Where there are multiple authors, presenters’ names are bolded and underlined




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                             Keynote presentation

        THE EFFECTS OF TRAUMA AND THE REFUGEE EXPERIENCE ON
       PSYCHOLOGICAL ASSESSMENT PROCESSES AND INTERPRETATION

                       Dr Ida Kaplan, Manager, Client Services,
                     Victorian Foundation for Survivors of Torture

All assessments occur in a cultural context, whoever the participants in that process.
When the participant being assessed is a refugee several contextual domains, both
current and historical require close attention.

These domains are:
   1. The effects of torture, violence and traumatic loss;
   2. Pre-arrival hardships which include poor nutrition, inadequate shelter, lack of
       access to health services and disruptions to schooling;
   3. Settlement stresses involving unfamiliarity with Australian systems and
       discrimination;
   4. Barriers to communication; and
   5. Family functioning and fractures to family nurturance, maintained by ongoing
       separation from and dangers to significant others left behind.

    Given that the purpose of assessment is to formulate appropriate interventions for
promoting mental health, learning and well-being for individuals presenting with
special needs, professional expertise demands a comprehensive analysis of the causes
of identified problems. Case examples will be presented to highlight the relationship
between a comprehensive assessment, including testing, and the application of
suitable interventions. The concept of “trauma-informed care” will also be discussed.

   Professionalism needs to uphold certain principles as part of best practice.
Foremost is the need to respect and reinforce human rights in a culturally responsive
way when the service user has been subjected to extreme human rights violations.




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         NEUROPSYCHOLOGICAL ASSESSMENT ACROSS THE LIFE SPAN:
                    CROSS-CULTURAL CHALLENGES

   Alan Tucker, PhD, Coordinator, Doctor of Psychology - Clinical Neuropsychology,
                 School of Psychology, Victoria University, Melbourne

In practice the spectrum of neuropsychological work includes assessment of people at
each stage of the life span. This includes preschoolers, children of school age (both
primary and secondary), and people in early, middle and late adulthood. The range of
brain conditions that prompts neuropsychological assessments varies from suspected or
documented developmental disorders, such as autism spectrum disorders, and learning
disability, to acquired brain impairment, such as traumatic brain injury, stroke and
dementia. Key tasks for the neuropsychologist include the assessment of the
individual’s cognitive and emotional functioning and their relationship to development,
medical history, current diagnoses, treatments, current problems, education,
occupational history, and the context of the person. The “context” factor includes the
individual’s family relationships, social setting and cultural history.

       In the last decade there has been an increased awareness of the potential
impact of culture on the results of cognitive and emotional assessment instruments,
including the “normative” data bases for such instruments. As Australia has a large
number of people, at various stages of the life span, from culturally and linguistically
diverse (CALD) backgrounds the impact of culture on neuropsychological assessment is
especially important in various educational, occupational, community and personal
settings.

       The present paper reviews selected aspects of the international literature on
CALD issues of neuropsychological assessments as well as the contemporary Australian
practice. Case examples are presented to illustrate some of the current challenges for
neuropsychologists and others wanting to utilize these neuropsychological findings. The
implications for neuropsychological training are also addressed.




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               NEUROPSYCHOLOGICAL CROSS CULTURAL STUDY
          OF COGNITIVE PERFORMANCE OF GREEK AUSTRALIAN ELDERLY
                AND EXPLORATION OF DIAGNOSTIC CHALLENGES

    Dr Areti Plitas, Neuropsychologist, Department of Psychology, Victoria University,
   Melbourne, Australia, Dr Alan Tucker, Dr Ada Kritikos, Izabela Walters, and Dr Fiona
                                       Bardenhagen

In the area of dementia diagnosis and assessment of cognitive functioning of elderly
culturally and linguistically diverse individuals (CALDI) little is known about cognitive test
performance differences between migrants and peers from their country of origin.
Although Australia is known for its multicultural society and Greek is one of the most
common languages spoken at home, few studies have compared cognitive test
performance between migrants to peers from their country of origin. This study
investigated whether the long-term migrant group of elderly Greek-Australians’ (GA)
performance on tests of cognition was comparable to a demographically similar group of
elderly Greek Nationals (GN). Based on available cross cultural literature it was
hypothesised that GA would obtain lower scores on tests of cognition compared to GN due
to issues relating to the migrant experience such as acculturation, reduced language
fluency and proficiency. The tests used in the current study are used internationally as
screening measures of cognitive functioning and assist with the diagnosis of dementia in
the elderly. These tests had been normed in Greece and raw data was obtained from
Greek researchers to allow for direct comparison between GA and GN.

        Participants’ cognitive functioning was assessed on the Cambridge Cognitive
Examination of the Elderly (CAMCOG) and the Mini-Mental Status Examination (MMSE). The
GA participants comprised 66 healthy, community dwelling, individuals recruited from
Melbournian Greek social clubs. They were aged between 56 and 88 years (group mean
age = 66.2 years, SD = 6.3). The GN participants were recruited by Greek researchers from
the 3rd Department of Neurology, Aristotle University Hospital of Thessaloniki and
consisted of 76 GN participants without dementia (Gn). Gn participants were aged
between 55 and 93 years (group mean age = 69.8 years, SD = 7.5). Although there were no
significant differences between the groups in terms of gender, GA participants were
significantly younger than Gn.

       The results of the current study supported the hypotheses that GA would obtain
lower scores on tests of cognition, as measured by the CAMCOG and MMSE, compared to
demographically similar group of non demented GN. In addition, there was a significant
interaction effect of gender; GA females obtained significantly lower scores than GA
males on CAMCOG and MMSE. Given the findings of the present study it was concluded
that caution be exercised when applying GN CAMCOG and MMSE norms to GA as these
norms could result in false positives, that is GA could be inaccurately diagnosed as
cognitively impaired and demented according to GN norms. Current findings also indicate
that GA females are at a higher risk of being inaccurately diagnosed. The significance of
these findings regarding CALDI assessment of cognitive functioning, in particular the risk
of diagnostic inaccuracy when applying norms from migrants’ country of origin and norms
developed from English speaking individuals, the utility of the CAMCOG and MMSE with GA,
and implications for future research are also examined.




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                               Keynote presentation
 TRANS-CULTURAL PERSPECTIVES ON THE DESIGN AND USE OF PSYCHOLOGICAL
  ASSESSMENT INSTRUMENTS, AND ANALYSES OF DATA DERIVED FROM THEM:
              DEVELOPERS, USERS AND CONSUMERS BEWARE

                   Dr Ken Rowe, Research Director, Learning Processes,
                        Australian Council for Educational Research

Observational and self-report psychological inventories are used routinely by psychologists
and psychiatrists as assessment instruments to assist with the evaluation of human
cognitive, affective and behavioural functioning. They are also used in epidemiological
studies to obtain normative/prevalence estimates of persons with personality and
behavioural ‘problems’. Advantages entailed in their use include ease of administration
and the convenience of obtaining estimates of psychosocial functioning from individuals
and large numbers of informants. However, there are two major problems in the design
and content of commonly used psychological assessment instruments. First, as a
consequence of cross-cultural variations within and between, socio-cultural groups, the
‘portability’ of such instruments in terms of understanding by respondents and subsequent
interpretation by clinicians is problematic at both the item and scale levels. Second,
serious decisions are frequently made on the basis of ‘measures’ obtained from such
instruments, including: selection/non-selection for further education and/or employment;
and the labelling of persons as ‘pathologic’, subsequent referral to intervention therapy
services, and prescription of medication by a physician.

        This presentation highlights key substantive and methodological issues endemic to
the design and use of cognitive and psycho-behavioural rating inventories, and the
analyses of data derived from them – especially in multi-cultural contexts. Moreover, the
presentation provides evidence indicating that traditional psychometric methodologies
employed to construct ‘scales’ (typically from dichotomous and/or ordinal item-response
formats) and to report ‘norms’, that ignore the sampling, measurement, distributional and
structural properties of the derived data, have long since passed their ‘use-by-date’. Also
demonstrated is that claims of validity and reliability employing these traditional
methodologies can no longer be justified. Using data obtained from the administration of
psycho-behavioural rating inventories in several large-scale research projects, these issues
are illustrated and discussed in terms their substantive implications for cross-cultural
psychological assessment. The outcomes of more robust methodologies are presented
that stress the need to revise the design of psychological assessment instruments, and
point to the adoption of more rigorous approaches to measurement and analyses of the
related data.




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   VALIDATION OF THE ROWLAND UNIVERSAL DEMENTIA SCALE (RUDAS) IN A
              MULTI-CULTURAL COHORT OF OLDER PERSONS

Freda Vrantsidis, Research Officer, Preventive and Public Health Division, National Ageing
 Research Institute, Keith Hill, David Basic, Jeff Rowland, David Conforti, Dina LoGiudice,
                       Jan Harry, Katherine Lucero & Robert Prowse

There is a recognised need for the development (and validation) of new dementia
screening tools that address limitations of existing tools. Previously identified limitations
include that tools are influenced by client’s level of education, cultural background or
gender. Furthermore, some aspects of cognitive function, such as frontal lobe function,
are not usually assessed. The Rowland Universal Dementia Assessment Scale (RUDAS), a
six item screening tool, was developed to address these limitations. The RUDAS assesses
several cognitive domains (abstraction, executive function, praxis and gnosis) and can be
directly translated into other languages without the need to change structure or format of
any item.

     Initial validation studies, conducted in Sydney where the tool was developed, found
that the RUDAS had high predictive accuracy for detecting dementia and was not
influenced by gender, years of education, differential performance factors or preferred
language. However, the initial studies were over represented with patients with
moderate-severe dementia.          This study aimed to evaluate the RUDAS in other
multicultural populations (Melbourne and Adelaide) and in populations with a broad range
of cognitive function, including those with mild cognitive impairment.

        151 people were recruited and assessed. Forty two percent of participants were
from a culturally and linguistically diverse (CALD) background. Participants completed a
series of cognitive assessments and measures of function and depression, in addition to
the RUDAS, Mini Mental State Examination (MMSE) and General Practitioner assessment of
Cognition Scale (GPCOG). Sixty percent of participants had some form of cognitive
impairment, of which 90% had questionable or mild impairment based on the Clinical
Dementia Rating scale. Each participant was assessed by a geriatrician, an aged care
psychiatrist or an advanced trainee in geriatric medicine, for a dementia diagnosis based
on the DSM-IV criteria. The medical staff also performed the MMSE and GPCOG. A research
officer completed the RUDAS assessment blinded to DSM-IV classification.

       The accuracy of prediction of cognitive impairment for the RUDAS against the gold
standard of the DSM-IV criteria was high. The area under the receiver operating
characteristic curve (AUC) was 0.94 comparing those with dementia to those with normal
cognition. Positive and negative likelihood ratios (LR) using the recommended cut point of
23 were 8.8 and 0.1 respectively. The RUDAS performed equally as well as the MMSE (AUC
0.92; positive LR 6.8 and negative LR 0.04) and the GPCOG (AUC 0.96, positive LR 5.0 and
negative LR 0.02). Multifactorial logistic regression identified that each of the cognitive
screening tools was a significant predictor of cognitive status after adjusting for other
covariates. However, the RUDAS was not influenced by other covariates, unlike the MMSE
(confounded by CALD status) or the GPCOG (confounded by GDS).

        These results add to previous validations of the RUDAS. They demonstrate high
predictive accuracy of the RUDAS in a sample incorporating a high proportion of
participants with mild cognitive impairment. The RUDAS performs at least as well as the
MMSE and the GPCOG, but with the added advantage of being more appropriate for use in
a multicultural population.




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THE KIMBERLEY INDIGENOUS COGNITIVE ASSESSMENT (KICA): DEVELOPMENT OF
  A COGNITIVE ASSESSMENT TOOL FOR OLDER INDIGENOUS AUSTRALIANS IN
          REMOTE AND RURAL AREAS OF THE KIMBERLEY REGION

   K. Smith1,2, A. Dwyer2, L. Flicker1, O. Almeida1, N. Lautenschlager1, J. Thomas1, D.
  Atkinson3 and Dr Dina LoGiudice, Consultant Physician Geriatric Medicine, Royal Park
 Campus Melbourne Health & National Ageing Research Institute, University of Melbourne
       1
        WA Centre for Health & Ageing University of WA, Australia 2 Kimberley Aged and
       Community Services, WA Australia , 3 Kimberley Aboriginal Medical Services Council,
       Broome WA, Royal Park Campus Melbourne Health & National Ageing Research Institute

Introduction: There is little research in the area of cognitive impairment and dementia in
Indigenous Australians. The Kimberley Indigenous Cognitive Assessment tool (KICA) was
developed to address a deficiency in appropriate cognitive assessment tool for older
Indigenous Australians particularly in remote and rural areas.

Method: The KICA was developed with Indigenous health and aged care organisations, and
comprises of cognitive, informant and functional sections. For the purposes of this paper
the psychometric properties of the cognitive assessment section (KICA-Cog) are described.
Validity was initially tested in 70 Indigenous subjects over 45 years of age, with varying
cognitive abilities and from diverse language and geographical regions of the Kimberley
region. Clients and carers were assessed by the KICA and then independently evaluated by
a geriatrician using DSM-IV and ICD-10 criteria. Inter-rater reliability was assessed in 14
subjects rated by two independent observers.

Results: The KICA Cog score showed no systematic difference between the two raters, the
mean difference was –0.07, standard deviation of difference between raters of 1.83.
Three items on the cognitive score (orientation, naming, registration, recall and free
recall) effectively discriminated 91.4% of cases. Sensitivity and specificity was 91% and
93%, respectively, using a cut off score of 31-32/39.

      The tool was tested again in two other populations using the same methods
described. Forty seven older people in the Northern Territory were assessed with the KICA
Cog. Sensitivity and specificity were 82.3% and 87.5% respectively using the same cut
point, with Area under ROC of 0.95. Verbal fluency, free recall and orientation of season
were correctly classified by 90.9% of cases. Minor modifications were made to the tool.
Subsequently, a prevalence study of cognitive impairment in the Kimberley was
undertaken and 363 participants were assessed using the KICA Cog. Sensitivity and
specificity of 93.3% and 94.8% respectively were determined, however with a cut point
redefined at 33/39, and area under ROC of 0.98. Five questions including orientation to
pension week, registration, recall, copying and free recall discriminated 96.7% of
participants.

Conclusions: The KICA appears to be a valid and reliable assessment tool for cognitive
impairment in an older Indigenous population. This paper describes the process of
development of the tool within rural and remotes areas of Australia and subsequent
utilisation and refinement of its components. It is now frequently utilised by health care
workers. Results on the prevalence of cognitive impairment and dementia in the
Kimberley will also be presented, indicating a higher prevalence ratio of 4.8 than non-
Indigenous Australians. The KICA tool can be found on www.healthykimberley.com.au .




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                                Keynote presentation

            PSYCHOMETRIC ASSESSMENT OF INDIGENOUS AUSTRALIANS -
                             WHERE ARE WE AT?

                  Dr Tracy Westerman, Indigenous Psychological Services

Research into the identification of mental health problems amongst Aboriginal populations
in Australian is still in its infancy, and debate therefore continues regarding the most
appropriate and culturally valid methods of assessment and psychological testing. Whilst
research is scarce, it has also traditionally focused on mainstream conceptualisations of
mental health and well-being, a by-product of which has been the need for Indigenous
views of unwellness to ‘fit’ within a monocultural view. This approach has failed to
advance understanding of indigenous mental health both in terms of prevalence and
phenomenology.       The presentation will begin by exploring current approaches to
assessment and testing of mental health problems in Indigenous populations, and will
argue that these fail to recognise that culture is proximal rather than distal to mental
health presentation in Aboriginal people.

      Whilst existing research has argued that clinicians acknowledge the relevance of
culture within testing and assessments of Aboriginal clients, it has also failed to provide
specific or empirically validated guidelines to this end. The clinician is therefore left to
grapple with the complexities of how and when cultural difference is having an impact on
the accuracy of testing and assessment. As such, the presentation will provide an
overview of the history of psychological testing with Aboriginal people. This will then lead
into a discussion of the impact of cultural difference in the presentation of mental
disorders and the evidence base regarding these differences. It is through the recognition
of such evidence that the most appropriate methods of testing and assessment can be
determined.


      The presentation will end by providing a number of empirical approaches to
providing culturally valid mental health assessments for Aboriginal populations. This will
include a review of a number of strategies that have been developed by the presenter in
her PhD research. These strategies have been developed to minimise the extent of bias
experienced by Aboriginal people in current mainstream mental health assessment. This
will include (a) an overview of a unique measure for identification of mental health
problems in Aboriginal people, the Westerman Aboriginal Symptom Checklist – Youth
(13 – 17 years) and the value of such an approach to developing a more enhanced
understanding of Indigenous mental health, and (b) the development of cultural validation
guidelines as a necessary pre-requisite to all psychological testing with Aboriginal people.




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                           DISABILITY OR DIFFERENCE?
                 HOLISTIC ASSESSMENT OF ESL REFUGEE STUDENTS

 Nicole Fraine, Guidance Counsellor (M.Clin Psych, Dip Ed), Brisbane Catholic Education,
 Mary Immaculate Primary School, & Rossana McDade, New Arrivals Officer, ESL, Brisbane
                                  Catholic Education.

Difficulties exist in assessing refugee students when questions arise about their eligibility
to access special needs resources due to a possible impairment. For example, their first
language is likely to be less developed than other culturally and linguistically diverse
students and they have often experienced significant trauma and relocation issues.
Despite broad acknowledgement of these challenges, there is little available methodology
for practitioners to conduct such assessment. It is proposed in this paper that any
psychometric assessment of refugees be part of a broader process, which aims to
understand and support the needs of all refugee students when they enter the Australian
school system.

        A case study is described outlining a 5-stage process developed at school level
within the Brisbane Catholic Education (BCE) system to effectively and respectfully
manage the requirements of all refugee students. For students identified as having more
significant challenges, a further, detailed assessment process is initiated. This assessment
is holistic, broad-based and culturally sensitive, involving data gathered from a variety of
sources (e.g., family, psychologist, class teacher, English as a Second Language (ESL) staff
and other relevant community members).

        The process begins at the time of enrolment, supporting every refugee student’s
learning throughout their time at school. The process is multidisciplinary, explicitly
outlining how relationships between school staff, key visiting staff (e.g., cultural liaison
officers), families and external agencies are initiated and maintained. At Stage 1
(Enrolment), parents are interviewed and background information is collected to inform
support needs. Stage 2 (Initial Data Collection) involves the school support team staff in
gathering data to inform planning for academic and other learning (e.g., social) needs.
Stage 3 consists of a Support Team Meeting to discuss implications of the data gathered.
In Stage 4, an Individual Learning Plan (ILP) is developed based on shared data, and this
information is shared with parents. During stage 5, a Review is conducted to inform future
planning. The ILP is then reassessed as appropriate.

        If a more significant concern is identified at any time during a student’s schooling
(e.g., a student is suspected of having an impairment), Stage 4b (Further Assessment) is
triggered. This stage may involve psychological or psychometric assessment. Factors
influencing performance of refugee students on assessments are considered and sole
reliance on standardised measures is cautioned against. It is recommended that
assessment be broad based and information collected from sources both inside (e.g.,
dynamic assessment conducted by Guidance Officer or ESL staff) and outside (e.g.,
medical assessments) the school. The use of non-verbal assessment tools and adaptive
behaviour checklists are discussed as part of this broader assessment process.

        An evaluation of the proposed support process is being undertaken at a local school
level for potential application across the Brisbane Archdiocese. The preliminary evaluation
process is qualitative in nature, involving a gap analysis, focus groups with relevant staff
and parent interviews. Initial feedback suggests that the process is improving student
outcomes and enabling the school to better support the needs of refugee students.




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 ISSUES IN THE INTELLECTUAL ASSESSMENT OF NEWLY ARRIVED POPULATIONS
                              IN SCHOOLS

 Susan Whitelaw, Psychologist, Department of Education & Early Childhood Development,
                                  Dandenong schools

Students arriving in Australia from countries torn by war and conflict have a number of
specific needs. Many have experienced poor nutrition, exposure to violence, poor health
care and little or no educational opportunity. They may come to school anxious to learn
and to make the most of the opportunities in our community, but many are experiencing
terrible odds that greatly reduce any chance of success.

      A significant number of these students have difficulty adapting to the demands of a
formal education system conducted in English, and are labeled as having ‘learning
difficulties’. They are frequently referred to psychologists for intellectual assessments
and may be assessed and labeled as having an ‘intellectual disability’ on the basis of their
performance on Western measures of cognitive ability. Psychologists are often forced into
a choice between carrying out these assessments and subsequent inappropriate labeling,
and leaving a student to flounder with no support.

This presentation will consider the following issues:

   1. The background experiences of refugee students;
   2. The difficulties of assessing intellectual disability in this group;
   3. The inappropriate nature of the present assessment requirements if these students
      are to receive any support from the Program for Students with Disabilities;
   4. Discuss suggestions for a more appropriate and psychometrically valid procedure
      that could be adopted; and
   5. Discuss some helpful school initiatives with refugee students and their families.




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Issues in Cross-Cultural Psychological Assessment Conference 2008


  DYNAMIC ASSESSMENT: ASSESSING METACOGNITION IN PEOPLE OF DIFFERING
           CULTURAL BACKGROUNDS IN AN EDUCATIONAL SETTING

          Frederick H Wright, Student Counsellor, Holmesglen Institute of TAFE,
              Doctorate in Education Candidate, University of New England

The emphasis of the discussion will be on using the Dynamic Assessment (DA) approach to
assess metacognitive processing of students of differing cultural backgrounds in an
educational setting. Researchers like Michael Cole (2005) have suggested that there are
differences across cultures in the way intelligence is defined and Sternberg (2003)
suggests that metacognition is important when defining what intelligence is across
cultures. Metacognition has been defined as: “thinking about thinking, knowing what we
know and what we don’t know. Just as an executive’s job is management of an
organisation, a thinker’s job is management of thinking” (Blakely & Spence, 1990).
Recent work, to be discussed briefly, has found differences in metacognition across
cultures.

     Haywood and Lidz (2007) have described DA as an appropriate approach to assessing
cognition across cultures. Reuven Feurerstein has argued for a considerable time that DA
provides a means to determine influences of cultural deprivation over organic deficit. DA
is an assessment approach that has its theoretical foundations in the work of the Russian
psychologist Vygotsky. The legacy of his work has seen the development of four main ways
in which DA is conducted, including use of, open-ended clinical enquiry, generic problem
solving tasks, graduated prompts, and, in educational settings, a curriculum-based
approach.

    DA is not based on a deficit model. It is an interactive approach where the
practitioner is actively involved with the participant in the assessment activity. It is
process, not outcome orientated. In other words it aims to inform on the key reasons for a
person responding in a particular way to task stimuli. And, commonly, it uses a test –
teach – re-test approach to understand ‘deficit’ and explore possible means for enhancing
performance. More broadly, it is possible from such work to develop a metacognitive
teaching approach.

    In this presentation I illustrate the use of DA with a case study involving the test –
teach – retest approach and, where possible, a curriculum focused metacognitive teaching
phase. Advantages and limitations of DA are discussed.




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