There seems to be an awful lot of testing in the current day and age. From early childhood all the way through to job interviews and ‘fitness to work’ and all that goes on in between; one can be ‘tested’, for example, in any of the following areas: educational evaluations, various developmental milestones, diagnostic assessments, psychometric testing, interviews, Doctoral viva, personality – the list could go on.
So? What’s the problem? What’s the point of this in relation to autism (NB this includes Asperger Syndrome).
The issue is fairness and equality, as well as accuracy of ‘results’. My critical premise is that a test for one person that provides accurate results may not give as accurate results for someone else who may process that test in a different way. If ‘testing’ is developed with the majority of the population in mind, then surely there is a reasonably robust argument to suggest that if one falls outside of the demographic majority then the test may not be as applicable in terms of efficacy and/or accuracy of results. Take the following example:
It is GCSE maths and the exam is imminent. An autistic pupil takes the test, but rather than following protocol, he simply answers the questions without showing how he has worked them out. His argument – which makes perfect sense to him – is that he doesn’t need to show how he has worked his answers out, as by getting them right it should be self-evident that he knows how to work them out. Conversely, he feels very strongly that should he get the answers wrong then he does not deserve any marks at all. He is, in fact, a very gifted mathematician.
In this example, the student may score fewer marks than someone who dutifully shows their workings out, and yet he may have answered all questions correctly. Is the test, then, an accurate reflection of mathematical ability, or a reflection on how well one engages with the test itself? In the case of the autistic student it would seem that it is the latter, and not the former. Subsequently, despite being excellent at maths, the student may not have the opportunity to have this reflected in his grade.
Another aspect of ‘testing’ that stands out for me is the job interview. I find it incomprehensible that most employers still use this form of assessment when trying to identify potential candidates for employment. Quite aside from the plethora of issues that face an autistic individual and the potential disadvantage they might face in an interview situation, logic alone dictates that demonstrating expertise within an interview is exactly that – being good at an interview. This does not necessarily correlate with being any good whatsoever at the job one is being interviewed for. The converse is perhaps far more important – representing poorly at interview does not necessarily mean that one is going to be an inadequate employee. So many people with autism bemoan the fact that interviews are the barrier that preclude them from gaining employment, despite feeling that they are well able to do the job. As someone mentioned to me, “instead of interviewing me, please just observe me doing the job for an hour instead – and judge me on that” – which I think in many cases is eminently sensible advice. Of course, it is not always practical, possible, pragmatic, or even appropriate to observe a potential employee at work – but it’s certainly an idea worth exploring to go some way towards making employment opportunities more available and, perhaps, fairer.
Taking the argument to a conceptual level, if any test is attempting to reflect the neurology of an individual in any way – then unless the test is adapted to suit the cognitive style of the ‘testee’ then how can results be said to be valid? Many (if not all) individuals with autism will have ‘spiky profiles’ – i.e. neurological strengths and weaknesses. This may result in an inaccurate reflection of both ability and difficulty. For example, an individual with autism may take a psychometric test to ascertain her intellectual quotient (IQ). The British Psychological Society (BPS) (BPS.org.uk, last accessed 12.11.15) note that tests are devised very carefully and that large numbers of people are used in a pilot. The BPS also acknowledge that tests will determine how ‘typical applicants’ score on the test. However, large numbers of people presumably don’t take autism in to account, and would an autistic person be considered a ‘typical applicant’? If results are taken at ‘face value’ without the individual’s neurological profile being taken into consideration, does this mean that the outcome is questionable? Quite possibly, yes.
As already noted in relation to job interviews, individuals may have good skill sets relating to employment but without the requisite skills at interview. There will also be situations – which can cause just as much distress – where judgements are made and assumptions formed about an individual’s level of skill in one area based on another. In other words, an assumption may be made along the lines of ‘well, he’s academically brilliant, so he simply must know that telling the truth about his neighbour’s weight problem to her face was a daft thing to do’. Well, for a person with autism his academic intellect may have nothing whatsoever to do with skills around what (and what not) to say to a neighbour. Such assumptions may be very dangerous indeed.
So, as (almost) always, the answer lies in treating the autistic person on an individual level, not using generic assessments but tailoring them to take the person’s way of communicating, interacting, and processing into account. Unless we make adjustments in how skills are determined, we run the risk of making erroneous assumptions around what a person can and can’t do – which, simply, seems unfair.
Yes there are many good points in this article.
I know someone with Autism who if you mention a date to him can tell you the day. He cannot tell you how he works it out.
Some Autistic people work out Maths answers in their head and do not use Paper. so cannot show a method.
Interviews are often unfair to Autistic people and to people who lack experience. I was once even asked Can I explain
complicated things to colleagues. ? Of course I cannot as Autism makes it harder to.
I also remember being asked what I would do about a suspect Parcel. I was told that one reason I did not get the job was because I gave the wrong answer. If you had not experience
working it is hard to get the right answer.
Filling in application forms I find difficult as they often do not give space to tell them what you want to tell them. I saw please show CV but they probably might not look at the CV.
I FULLY AGREE WITH THE ARTICLE ABOVE AND I RARELY SAY THAT.
David Shamash
Very many thanks, David – some very valuable points you have raised here. Taking time to comment is greatly appreciated!
I think that people who do not know much about autism will find your blog hard to access. Before I received a diagnosis for my eldest son, I did not really understand the challenges he would face. I fought tooth and nail for him as the years passed. Now it is just him and myself as his family and mine have rejected us because of his autism. They can not accept that he does not conform and they cannot forgive me for not trying to force him. I have lost all contact with my twin sons and my extended family because I refused point blank to give up on my elder son who is more severely autistic.
The question no one has ever been able to answer for me (as someone with Aspergers) in 11 years is why we still even use application forms and arbitrary job advertised descriptions when a CV and a professional portfolio is more meaningful – that and actually talking to people (still a sellers employment market it seems).
Something just feels wrong about proficiency milestones and years of experience prerequisites jobs require – I can read difficult classic philosophy, find novel problem solving solutions, can translate legal documents into easy-read autism friendly formats (self taught as an intern), have almost two degrees (no bragging or hubris intended) and can simply explain difficult ideas from at least five fields of research yet the humble job application form and ‘must have x years of work experience’ requirement derides all the above converting innate intelligence into simple ‘skills needed’ matrices only fit for typical learners and employees (just seems difficult to know what is sought or being measured as a concrete thinker).
Hi Like. Amazing article. I am so pleased and thankful you wrote this. CC is 11th-13th May 2016. Will keep you posted on outcome regarding this very subject. Best wishes.
Luke this is so true.
“The issue is fairness and equality, as well as accuracy of ‘results’. My critical premise is that a test for one person that provides accurate results may not give as accurate results for someone else who may process that test in a different way. ”
Incredibly, clinical psychologists are not on the ball with this either. For instance, testing on anxiety:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3162631/
“A review of the studies revealed that the assessment of anxiety in children with ASD varies enormously across studies with the majority using instruments that were developed to assess anxiety in typically developing children. The current state of research has not yet examined the validity and reliability of instruments used to assess anxiety in a typically developing population for the ASD population. However, such research is heavily needed. To date, the authors are only aware of one such study. Mazefsky et al. (2011) examined the sensitivity and specificity of self-report questionnaires in adolescents with ASD and compared these self-reports with the outcome of a parental diagnostic interview. Although conclusions are preliminary, the results suggest that such measures may be less sensitive and specific when used in adolescents with ASD than in similarly aged, typically developing adolescents. This may be because children with ASD underreport (anxiety) symptoms (Russell and Sofronoff, 2005). On the other hand, comparing results from self-report measures with parental diagnostic interviews may be problematic as child and parent agreement for anxiety is generally low in typically developing children and the level of agreement may be even less in children with ASD (e.g., children with ASD may lack sufficient insight or emotion language to report accurately on their internalizing symptoms).”
Our child’s psychologist relied on self-completed anxiety rating scales by a young autistic child who could not express her anxiety levels accurately (potential alexithymia too) and produced a report claiming her anxiety was low. It was in fact through the roof! So the report was useless and impossible to use in gaining her support because it was inaccurate. Even worse, suggestion was made that I was perceiving her anxiety as different than it actually was, in other words exaggerating it.
Subsequently she was found to have PDA (as well as HFA), which is a wholly anxiety driven condition.
So it becomes dangerous when clinicians are relying on the autistic child’s self-reports, using NT researched tests which are inaccurate in autistic children and then falsely blaming the parent for misrepresentation.