Can clinical judgement overcome flawed materials when assessing black children: The need for more intervention-based pedagogy and less assessment negligence

The first Black school psychologist in the U.S., Albert Sidney Beckham, was far from the only Black psychologist to utilize cognitive assessment instruments with Black students (Graves 2009). For instance, Martin Jenkins, the former President of Morgan State University, was a pioneer in the field of gifted education who frequently used IQ tests to identify students as gifted and talented (Jenkins, 1943). Herman Canady, who was the Department Chair at West Virginia Collegiate Institute (now West Virginia State University), was one of the first psychologists to publish research on rapport and intelligence (Canady, 1936). Others such as Howard Hale Long used intelligence tests in their research on the correlation between socioeconomic status and performance in elementary school (Long, 1935). In each instance, Black psychologists sought to use cognitive assessment instruments to demonstrate that Black children were as intelligent as their White peers. This approach represents a significant departure from the views of Black psychologists during the 1960s and 1970s (Williams 1974). This time period saw the Association of Black Psychologists call for a moratorium on testing with Black children (Williams et al., 1980). These events culminated in the Larry P. v. Riles case brought forth by parents of children placed in special education, the Association of Black Psychologists, and the National Association for the Advancement of Colored People (NAACP). The outcomes of this case led to the ban on the use of intelligence tests with Black children in California. Approximately 40 years later, the outcome of this case is still highly debated in the school psychology community (Gamble & Hiramoto, 2021; Woods & Graves, 2021).

In their article, Aston et al. (2022) focus on how Culturally Relevant Clinical Judgment could potentially improve the assessment practices of school psychologists in relation to evaluating Black children for special education eligibility. This research is timely given the fractured nature of assessment practices and divergent views of school psychologists in regard to what constitutes appropriate psychoeducational practice and disability identification procedures. In Maki et al. (2015) examination of state learning disability (LD) eligibility criteria, there was no national consensus on how this disability should be operationalized. More specifically, 16% of states prohibited the use of any method other than response to intervention (RtI); while 20% of states explicitly prohibited the use of the ability–achievement discrepancy approach. Additionally, researchers have found issues with the validity of cognitive assessments, which are often a cornerstone of eligibility evaluations. For example, Graves et al. (2021) found that the factor structure of the most commonly administered cognitive assessment instrument in the U.S. (i.e., WISC-V) was not invariant by race. Additionally, Woods et al. (2021) examined cognitive ability and reading achievement scores on the Woodcock-Johnson-IV for 9–13 year old Black, Hispanic, and White students; their results indicated that models using Cattell-Horn-Carroll (CHC) theory broad abilities to predict reading achievement were a poor fit. From a historic standpoint, these issues are not new, with proponents of IQ testing (see Schneider & Kaufman, 2017) maintaining that these tests are important for understanding the educational and psychological needs of students. In contrast, others have stated that implementing and monitoring interventions in general educational classrooms is the most equitable and efficient method for identifying needs and improving achievement (see Burns et al., 2020).

As such, the research by Aston et al. (2022) presents an interesting concept, given extremely divergent views in the field of school psychology. In the following paragraphs, I will discuss issues related to how clinical judgement has been exercised when it comes to Black populations.

Implications of clinical judgement

In the field of school psychology, clinical judgement is extremely important. In their examination of specific learning disability identification methods, Maki and Adams (2020) found that identification consistency differed based on the type of method used (i.e., RtI, ability-achievement discrepancy, or pattern of strengths and weaknesses). This indicates that a practitioner's clinical judgement can have a significant impact on placement decisions.

Social psychology has also demonstrated that Black children are not viewed the same as their White peers. For instance, Cook and Halberstadt (2021) utilized a sample of adults who were parents of children between the ages of 3–18 to complete an emotion understanding paradigm that consisted of a balanced number of Black and White child actors (ages 10–13) expressing emotions (e.g., fear, surprise, sad, disgust, happy). Their results indicate that participants did not view Black children as older than White children, which has been found in other studies (Halberstadt et al., 2022). However, Black children were 1.27 times more likely to be misperceived as angry in comparison to their peers. These notions about Black children have also been replicated with preservice teachers. Using a vignette study, Kunesh and Noltemeyer (2019) asked pre-service teachers about their views of defiant students. Teachers read three versions of the vignette in which the race of the child was experimentally manipulated (e.g., stereotypical Black name with statement of students race as Black, stereotypical White name with statement of students race as White, and stereotypical Black name without explicitly stating race). Their results indicated that preservice teachers were more likely to believe that the student would have future behavioral issues if the they had a stereotypical Black name.

The medical research also supports the notion that the clinical judgement has an impact on individuals’ perception of Black pain. Given that African Americans are undertreated for pain in comparison to their White peers, Hoffman et al. (2016) examined whether this racial bias was related to false beliefs about biological differences between Blacks and Whites (e.g., Black people's skin is thicker than White people's skin). Medical students in this study endorsed these beliefs and rated Black patients’ pain as lower. This led to less accurate treatment recommendations. These findings suggest that even highly educated individuals, such as medical students, may hold biased beliefs about biological differences, which can inform their clinical judgement. Consequently, clinicians across a variety of helping service professions may have specific views of Black populations that impact their clinical decision making.

Outcomes associated with clinical judgement

The outcomes associated with clinical judgement are not trivial. Research using nationally representative samples of students with mild disabilities indicates that special education services have little or no effect on the average recipient's level of academic achievement (Morgan et al., 2010; Sullivan & Field, 2013). Furthermore, national data also demonstrate that minoritized students have slower growth trajectories and show fewer gains when placed in special education than their White peers (Graves & Ye, 2017). This type of clinical judgement is also seen in the behavioral domain. For instance, Graves and Wang (2022) examined the relationships between body mass index (BMI), school belonging, and suspension in a nationally representative sample of 7th-12th graders. Their results indicated that BMI was a significant predictor of school suspension for the overall sample, but not for Black boys. This indicated that regardless of size, Black boys were subjected to more exclusionary discipline practices.

Issues with response-to-intervention

The aforementioned research would seem to support Aston et al.’ (2022) contention that Culturally Relevant Clinical Judgement is needed to help support Black students, especially given the problematic use of cognitive testing. Nonetheless, there are also issues with the exclusive use of RtI for disability identification. As indicated by Burns et al. (2020), low performing students who receive targeted and quality interventions demonstrate growth at more significant rates than children who are placed in special education. This success is admirable; however, the research base for interventions to improve outcomes of Black youth specifically is underexplored. Lindo (2006) examined the African American presence in reading intervention research and found that, of the 79 reading studies found, none reported outcomes by race and only two had a majority of African American participants. Although this study is two decades old, its implications remain relevant. In their systematic review of race and ethnicity in educational intervention research in the What Works Clearinghouse (WWC) database, Gaias et al. (2020) found that 27% of empirical studies and 94% percent of meta-analyses did not report race or ethnicity. Relatedly, Same et al. (2018) conducted a systematic review of evidence-supported interventions associated with Black students’ educational outcomes. Their results indicated that none of the 53 studies found provided strong or moderate evidence as described by WWC guidelines, while 22 studies offered promising evidence. Taken together, these studies indicate that there are several limitations to the RtI research base when it comes to empirically validated interventions for Black children.

Summary

Aston et al.’ (2022) concept of Culturally Relevant Clinical Judgement has the potential to move the field of school psychology forward as it relates to Black children. Aston and colleagues, like Albert Beckham and the first generation of Black psychologists, do not discourage the use of intelligence tests with Black children but rather encourage the use of Culturally Relevant Clinical Judgement making when making decisions. To actualize this, the field of school psychology, like all social sciences, would need to view Black children in a different light. Consequently, continued research on how Culturally Relevant Clinical Judgement impacts outcomes is warranted.