OS C5 I .11/2.: 78-4- BISON Testing the Handicapped for Employment Purposes: Adaptations for Persons With Motor Handicaps m United States Civil Service Commission Bureau of Policies and Standards suNY AT sur;~~o iHE. \.IB[;AR:E 1 1665 OEPOSI rorrt COPY PS 78-4 TESTING THE HANDICAPPED FOR EMPLOYMENT PURPOSES: ADAPTATIONS FOR PERSONS WITH MOTOR HANDICAPS Karen Olivia White United States Civil Service Commission Bureau of Policies and Standards Personnel Research and Development Center Test Services Section September 1978 TESTING THE HANDICAPPED FOR EMPLOYMENT PURPOSES: ADAPTATIONS FOR PERSONS WITH MOTOR HANDICAPS Ao&tract This paper provides recommendations for test developers and examiners responsible for testing motor handicapped adults for employment purposes. Brief descriptions of some orthopedic, muscular and neuromuscular conditions are presented as well as information about language impairments which frequently accompany neurological disorders. A review of the relevant testing literature discusses the psychological, physical and psychometric some of the modifications considerations affecting the testing situation and presents suggested. Recommendations for the modification of examining procedures are based on the functional limitations of the applicant. i Introduction Definitions and Descriptions Orthopedic Impairment Muscle System Impairment Neuromuscular Impairment Language Disorders Review of Literature Psychological Considerations Physical Considerations Psychometric Considerations Examining Procedures Pretest Considerations Recommendations for Modification of Examining Procedures Reference List CONTENTS 1 1 2 2 2 4 4 5 5 6 7 8 9 11 ii TESTING THE HANDICAPPED FOR EMPLOYMENT PURPOSES: ADAPTATIONS FOR PERSONS WITH MOTOR HANDICAPS This report provides recommendations for modifications of test content and test administration procedures which are intended to minimize the physical barriers encountered by motor handicapped job applicants when 1 being evaluated for employment purposes. As of this writing, an extensive review of the published literature has revealed no research in the specific area of selection testing; however, for over 40 years, professionals in the fields of medicine, education and vocational rehabilitation have been concerned with the problems involved in the assessment of the mental abilities and characteristics of persons with motor handicaps. The focus of this concern has been the interference of the motor handicap with the physical activities associated with taking standardized tests and the resulting interference with test scores. Most of the research studies, literature reviews and textbooks published in this area deal with the assessment of intelligence, personality and interests of children and/or severely disabled adults. No reports were found which identify specifically the degree of limitation which describes the employed or employable motor handicapped population: the broad range of types and degrees of motor handicapping conditions make classification difficult and comparison almost impossible. The information given in this report has been assembled from many varied sources which have provided a basis for extrapolating specific recommendations for examining procedures which will allow the fair evaluation of motor handicapped job applicants. For the reader who has had limited experience working with motor handicapped individuals, brief descriptions of some orthopedic, muscular and neuromuscular conditions are given in the first section. A dis cussion of speech disorders, though it may appear to be out of place in a paper on motor handicaps, is included in this sec tion due to the high incidence of communication problems among persons affected by neuromuscular impairments and due to the importance of communication in the testing situation. The second portion of the paper discusses some of the psychological, physical and psychometric concerns expressed in the testing literature about test materials and administration procedures used with motor handicapped persons. Recommendations for examining procedures to be used when testing motor handicapped applicants are outlined in the last section. Definitions and Descriptions The Rehabilitation Act Amendments of 1974 (PL 93-516) define a "handicapped individual" as "any person who (A) has a physical or mental impairment which substantially limits one or more of such person's major life activities, (B) has a record of such an impairment, or (C) is regarded as having such an impairment." This section is included in order to introduce the reader to some of the conditions covered by the term motor handicap. Brief descriptive summaries are presented with definitions of some of the less familiar terminology. These summaries cannot adequately reflect the complexity of the medical knowledge collected by specialists in the various fields, nor can they reflect the differences of opinion existing among professionals regarding the causes or etiology and classification of some handicapping conditions (e.g., cerebral palsy).· Motor handicapping conditions can be classed into three types: (1) orthopedic Severely handicapped applicants for Federal employment can be selected on the basis of demonstrated ability by the use of special appointing authority under which the usual competitive examining procedures can be waived. For those who prefer to compete for a regular competitive career appointment, examining procedures must be available which validly test the abilities measured in a manner unaffected by the presence of the handicap alone. 1 conditions, (2) muscle system impairments and (3) neuromuscular disorders. Orthopedic conditions are those which primarily affect the skeletal system or the joints and connective tissues (e.g., tendons and ligaments). Conditions which primarily attack muscle tissue have been categorized as muscle system impairments. Disorders of the nervous system, especially the brain and spinal cord, are classified under neuromuscular impairment. Finally, a brief introduction to speech disorders is presented to familiarize the reader with another handicap frequently associated with neuromuscular impairment. Orthopedic Impairment Postural defects. Spinal curvature · can result from developmental muscular weakness, malnutrition, trauma, disease and congenital conditions such as unequal leg length. It. is usually one of two types: in kypholordosis, the head protrudes forward, upper and lower back is rounded and shoulders are stoop~d; scolio~is (l~teral curvature) describes an "S" or "C" shaped back where one shoulder is higher than the other, the hips and chest cage are twisted and severe slumping due to muscle weakness and fatigue is observed (Connor, 1967). Rheumatic and arthritic diseases. Rheumatic diseases are characterized by pain and stiffness in parts of the musculoskeletal system including connective tissues. When the disease is located in the joint itself, the term arthritis is used. The affected joints are subject to swelling, fever, pain and stiffness and, in some cases, they may become fused. Some forms of disease are caused by an identifiable micro.organism, metabolic disorders (gout) or direct trauma to the joint. There are other forms for which the etiology is uncertain though they are thought to be caused by a microorganism which has not yet been identified. Persons who have rheumatic or arthritic conditions need frequent mild exercise and movement to prevent joint stiffening and increased pain (Hollander, 1966). Muscle System Impairment Muscular dystrophy. Several muscle wasting disorders, most of which are hereditary, are classified under the term muscular dystrophy. The major types are pseudohypertrophic (Duchenne), facio scapula-humeral (Landouzy-Dejerine), limbgirdle (Erb's juvenile form) and muscular dystrophy of late onset. All types are characterized by weakness of the affected muscles, though the progression of the wasting varies and may be delayed by physical therapy. Although pseudohypertrophic dystrophy begins in early childhood and its victims usually do not survive their teens, persons affected by the other major types often live an average life span with slight to moderate disability (Muscular Dystrophy Association, 1977). Myositis. Two very similar disorders of unknown etiology are poliomyositis and dermatomyositis. The major difference between the conditions is a reddish skin eruption of the face and.upper trunk which accompanies the latter disorder. The myosites are characterized by weakness and, in some cases, pain in the muscles of the trunk, especially the shoulders and pelvis. Progression is variable and unpredictable though corticosteroid therapy may cause considerable recovery of strength (Ogg, 1971). Myasthenia gravis. The cause of this disease is unknown though it is known that it is neither contagious nor hereditary. It produces no wasting of nerve or muscle tissues and usually no pain or nervous symptoms. It is characterized by "grave muscle weakness," hence its name, but a brief period of rest brings a return of strength. Since the mid-1930s, it has been treated with drugs which restore individuals to about 80% of their normal functioning (Ogg, 1971). Neuromuscular Impairment Cerebral palsy. The term cerebral palsy covers a broad variety of muscular dysfunctions which are thought to be related to congenital, nonprogressive brain lesions. There are a number of different systems used to classify these dysfunctions but they are generally described in terms of the parts of the body involved (topographic classification) and the major type of involvement (physiologic classification). The following descriptions are summarized from the classification system developed by the American Academy for Cerebral Palsy (Denhoff & Robinault, 1960). 2 Topographic Classification Monoplegia one limb Paraplegia legs only Hemiplegia one side of the body Quadriplegia all extremities Diplegia same part on both sides of the body Double hemiplegia similar to quadriplegia but implies greater dysfunction in arms than in legs · Physiologic Classification Spasticity-characterized by an exaggerated stretch reflex causing prolonged muscle contraction and clonus (alternating contractions and partial relaxations of a muscle). The pathologic stretch reflex must be present to warrant a diagnosis of spasticity. Rigidity-similar to spasticity, with the distinction that in rigidity there is greater resistance to slow voluntary motion while in spasticity there is greater resistance to rapid motion. Stretch reflexes are normal or · diminished; there is no clonus and no involuntary motion. Athetosis-characterized by involuntary and incoordinate motion with varying degrees of muscle tension. Ataxia-a disturbance of kinesthetic or balance sense marked by failure of muscle coordination. Muscle tone may be diminished or com~ pletely absent and there is usually some disturbance of visual perception. Tremor-describes a condition in which contractions occur alternately in the agonist and antagonist muscles. (Agonist and antagonist muscles are muscles which act in opposition to one another to cause the flexion and extension of a joint. For instance, the biceps of the upper arm causes the arm to bend, while the triceps straightens the arm.) These motions may be intermittent or constant and may occur as resistance to voluntary motion. Atonia-rare in pure form but is characterized by lack of muscle 3 tone and failure of muscles to respond to volitional stimulation. Frequently, one person will be affected by more than one type of motor symptom but the predominant motor symptoms generally determine the classification (Connor, 1967; Denhoff & Robinault, 1960; Hewett, 1974). Paralysis. · Paralysis is a condition involving the inability to use the affected muscles due to a lesion somewhere in the brain or in the neural pathway from the brain to the part of the body affected. The loss may be only partial, in which case the term paresis is used. Incoordination, spasticity, tremor and/or language disorders may also be present. The topographic classi fications are the same as those outlined above for cerebral palsy. Common causes are trauma (direct injury to the brain or spinal cord), cerebrovascular accident (stroke) or residual weakness due to an earlier attack of a disease ·such as poliomyelitis (Connor, 1967). Multiple sclerosis. A degenerative neuromuscular disease, multiple sclerosis produces a variety of symptoms, such as numbness, blurred vision or excessive fatigue in the earlier stages, which may partially or completely diminish for long periods of time. As the disease progresses other symptoms appear in the form of weakness·, incoordination, instability of gait, spasticity, visual impairment or paralysis. Age of onset is usually between 20 and 40 but the progression of the disease is unpredictable. One study of multiple sclerosis revealed that 43% of the survey population were still working 17 years after their first attack (Angel, 1969).. ' Parkinson's disease. Parkinsonism is a slowly progressing neuromuscular disorder which usually does not begin before the age of 50. It is characterized by tremor, rigidity, akinesia (lack of balance sense) and "freezing" (difficulty in initiating movements and slowness in performing them with frequent interruptions of performance). Other symptoms include muscular weakness, fatigue and involuntary motions of the jaw, mouth and lips which produce a characteristic Parkinson whisper. These symptoms can be partially ameliorated through chemotherapy, particularly the use of levo-dopa, a relatively recent development, and physical therapy (Blonsky, 1971). Language Disorders no studies were found which concerned testing motor handicapped persons for employmentDisturbances of the central nervous purposes. However, Angel (1969) lists over system often impair an individual's ability 250 occupations which can be performed by to communicate. The impairment may be adults who are handicapped by any of 14 directly related to motor dysfunction causconditions, including cerebral palsy, multiing unintelligible speech, illegible hand ple sclerosis and paraplegia. Also, Haber writing, diff~culty of visual fixation due (1973), reporting data based on the 1965to involuntary eye movements or limitations Census of the Population of the United. of the visual field due to restriction of States, revealed that 55.6% of men who had vertical eye movement. Frequently, however, severe functional limitations were employed ~:eu!:p~~:m~:~c!~~~!~e:~~~l:a~;cl:~~~~~~.2 in 1965. The percentage was lower for women who were functionally severely limited There are many classifications of these but 26.9% were employed in 1965. These impairments, all of which are believed to studies indicate that even an applicant who be caused by a lesion or lesions in a might be considered severely disabled by an cerebral hemisphere, but basically three individual unfamiliar with handicapping contypes can be identified'(Wepman, 1962). ditions could well perform the functions ofmany jobs and should be given every opportuniAgnosia. In this disorder, reception ty to demonstrate his or her abilities whenor comprehension of verbal or sometimes evaluated for employment as is required by geometric material is disrupted. Agnosias law. can be visual, involving written material, or they can be auditory, affecting the The Rehabilitation Act of 1973 (PL 93 understanding of speech though no hearing 112 as amended by PL 93-516) requiresloss is present. affirmative action in the employment ofhandicapped persons by the Federal governmentApraxia. This is an expressive dis (Section 501) and by Federal contractorsorder characterized either by an inability (Section 503) and prohibits discrimination onto recall the sound patterns used in speech the basis of handicap by any institution, or an inability to remember how to write agency or program receiving Federal financial letters, numbers or words. assistance (Section 504). The Department ofLabor has issued regulations to implement Aphasia. This disorder is an overall Section 503 of the Act (published in the language dysfunction of the ability to formFederal Register on April 16, 1976) and theulate or comprehend letters, numbers or Department of Health, Education and Welfarewords along auditory, visual and oral path has issued regulations to implement Section ways. 504 for recipients of its funds (published inthe Federal Register on May 4, 1977). In As found in other neurological disaddition, the U.S. Civil Service Commission orders, an individual may display symptoms enacted on April 10, 1978 a procedure forof more than one type of language dysfunc processing complaints of discrimination on tion in varying degrees. This has caused the basis of handicap in Federal employment. some disagreement among professionals in All of the above-cited regulations containthe field concerning terminology and classisections dealing specifically with employ fication (Levita & Riklan, 1973) but the ment selection criteria. predominant symptoms generally determinethe classification used. There are three major areas of concernregarding the testing of motor handicappedpersons: (1) psychological factors relatedReview of Literature to the limited opportunity for social interaction frequently imposed by a handicap,Most of the modifications of test (2) physical factors which must be considered materials and administration procedures rewhen selecting test material and (3) changesported in the literature were tailored for in psychometric properties of standardizedseverely disabled children and adults and tests which are modified in some way toaccommodate a handicap. 2see van Rijn, P. P. Testing the handicapped for employment purposes: Adaptations forpersons with dyslexia for a detailed discussion of other types of language disorders. 4 Psychological Considerations Limitations of mobility often limit a handicapped person's opportunities for social interaction (Schlenoff, 1974). The effects of such limitations vary and may depend largely on the extent of the handicap and the age of onset; for instance, a person who is disabled later in life may experience little significant impairment of the ability to meet and deal with others. However, for persons whose handicaps have imposed lifelong restriction on social activities, formal testing situations may be strange and disturbing (Anastasi, 1976; Bice, 1948; Diller, 1962; Doll, 1951; Glick & Donnel, 1953; Jewell & Wursten, 1951; Mase & Williams, 1962; Muthard & Hutchison, 1968; Reynell, 1970; Venardos & Harris, 1973). The problem of test anxiety due to the strangeness of the testing environment is usually considered to be primarily a function of the examiner's attitude toward the applicant. Much attention is given to emphasizing ability rather than disability and accepting the handicapped person as an independent, fully-functioning individual. A straightforward, professional approach is recommended; a handicapped person should receive the same consideration, patience and tact which should be shown any applicant. Furthermore, prior experience with motor handicapped persons plus knowledge of the limitations characteristically imposed by specific disabilities are desirable examiner qualities although this is not always possible in personnel testing situations (Bice, 1948; Diller, 1962; Holden, 1951-52; Jewell & Wurston, 1951; Roeher, 1961; Venardos & Harris. 1973). Venardos and Harris (1973) were the only researchers to report experimental results on test anxiety and methods of minimizing this factor. They administered the Wechsler Adult Intelligence Scale, the 16 Personality Factor Questionnaire (16 PF), the Purdue Pegboard (Purdue) and the Crawford Small Parts Dexterity Test (Crawford) to 72 clients at a rehabilitation center. Before the tests were administered, three groups of clients were given treatments designed to reduce anxiety. One group heard a tape recording on relaxation techniques, another heard a test orientation tape and were given test practice booklets and the third had a supportive, therapeutic interview in which they were encouraged to express their feelings. A control group received no pretest treatment. Using performance on the Purdue, Crawford and the second-stratum factor of Anxiety of the 16 PF Questionnaire as measures of test anxiety, there were no significant differences among the four groups. Subjective evaluations by the clients themselves, however, were very favorable with many asking to hear the tapes a second time. While the evidence that test anxiety is a major factor in the test performance of handicapped persons is sparse, the necessity for selecting test materials which are appropriate to the physical reality of a motor handicapped person is intuitively obvious. Physical Considerations The second major factor mentioned in the literature concerned the selection of appropriate test materials for use with handicapped persons. The concerns centered around two distinct features: the verbal content of a test and its performance requirements. The content of some test materials depends on unimpaired physical experiences for "correct" standardized responding. Linde and Patterson (1958) report that an item analysis of the Minnesota Multi-phasic Personality Inventory given to 33 cerebral palsied adults revealed that their realistic responses were being scored as abnormal. An example given was "I have never been paralyzed or had any unusual weakness in the muscles" to which an answer of "false" was scored abnormal. Schlenoff (1974, p. 362) points out that "a palsied child may consider walking to the store an insurmountable task, while a physically intact youth might take such an action for granted." Modifications of test content reported in the literature include pictorial as well as verbal material. Some Thematic Aperception Test cards have been adapted to show handicapped individuals in the pictures (Greenbaum, Quatere, Carruth,& Cruckshank, 1953). Reynell (1970) used only test materials which have been found to be familiar to most handicapped children when constructing a verbal comprehension test for severely handicapped 1-5 year olds. The U.S. Civil Service Commission's Professional and Administrative Career Examination has been adapted for both visually handicapped and deaf applicants both forms of which were carefully constructed to exclude as much as possible any material which involved experiences of sight or hearing, respectively. 5 The ability to perform certain tasks usually associated with test behavior, especially with paper and pencil tests, is affected by the motor handicapped person's strength, coordination and stamina. The most apparent effects for the majority of motor handicapped persons are on speed of performance and susceptibility to fatigue and, consequently, the use of tests which require timed, continuous administration to obtain meaningful results is almost categorically opposed (Allen, 1958; Allen & Collins, 1955; Anastasi, 1976; Boone, 1959; Coleman & Dawson, 1969; Cull & Hardy, 1971; Doll, 1951; Dudley, Doehring,& Coderre, 1969; ~air & Birch, 1971; Goldberg, 1960; Holden, 1951; Jewell & Wursten, 1951; Muthard & Hu~chison, 1968; Reynell, 1970; Schlenoff, 1974). Where motor handicapped persons have not been excluded as untestable, the most common procedure has been to use standard instruments adapted on a case by case basis. Untimed administration and/or the allowance of frequent rest breaks were the most often reported departures from traditional standardized test procedures (Allen & Collins, 1955; Anastasi, 1976; Boone, 1959; Cull & Hardy, 1971; Dudley,et al., 1969; Fair & Birch, 1971; Garron, Klawans, &_Narin, 1972; Holden, 1951; Jewell & Wursten, 1951; Kaufman, 1966; Muthard & Hutchison, 1968; Reynell, 1970). Other modifications of administration procedures were proposed for use with the severely handicapped and include pantomime, gestures or pointing and the utilization of a signal code as a means of indicating the desired response (Allen & Collins, 1955; Anastasi, 1976; Holden, 1951; Kaufman, 1966; Reynell, 19~0; Sterne, 1966; Wachs, 1966). These modifications are explained in detail in the last part of this report. Though widely accepted, such adaptations can be extremely dependent on the knowledge and experience of the examiner. (For example the use of pointing as an indicator of the chosen response of a person handicapped by incoordination requires careful observation and a certain amount of practice.) Many authors have emphasized the concentration of research effort toward the development of many more standardized tests, such as Raven's Progressive Matrices, which are appropriate with little or no modification for administration to most handicapped persons (Allen, 1958; Anastasi, 1976; Boone, 1959; .Cull & Hardy, 1971; Doll, 1951; Holden, 1951; Jo~es, Dayton, Bernstein, Strommen, Osborne, & Watanabe, 1966; Kaufmann, 1966; Reynell, 1970; Sterne, 1966). The most suitable tests are short, untimed, usually nonverbal and need no manipulation of test materials by the subject. Psychometric Considerations There are two major psychometric concerns in the modification of administration procedures~ effects of the adaptations on the psychometric properties of the test (i.e., the mean, standard deviation and reliability) and on its factor composition (i.e., what the test measures). Those authors whose recommendations were applicable primarily to severely handicapped children and adults encouraged a certain amount of caution in the interpretation of scores resulting from radically modified tests (Allen, 1958; Allen & Collins, 1955; Bice, 1948; Holden, 1951; Je~ell & Wurs_ten, 1951; Reynell, 1970; Wachs, l~t>6) ._ Those authors reviewing tests which require little or no adaptation report results which they feel are generally comparable to those obtained from the standard population (Allen & Collins, 1955; Anastasi, 1976; Boone, 1959; Cull & Hardy, 1971; Holden, 1951·; Kaufman, 1966; Reynell, 1970; Sapinkopf, 1978; Schlenoff, 1974; Schontz, 1957; Sterne, 1966). Very few data are available·regarding the effects of changes in administration procedures on the statistical properties of standardized tests. What has been reported thus far tends to support the assertion that to the extent that an instrument is a power test, 3 minor adjustments in examining procedures will not significantly alter the psychometric properties of th-e instrument. In a study of the effect of rest breaks on test performance, Fair and Birch (1971) administered Parts A and B of the Advanced Stanford Achievement Test Social Studies Section to ten physically handicapped and ten nonhandicapped school children. Half the students in each group were allowed to rest 10 minutes between Parts A and B while the control students were not given a rest break. Analysis of mean scores on Part B 3See page 9 for a definition of a power test. 6 between conditions in each group revealed no significant difference between experimental and control group scores among nonhandicapped students (t = .414, df = 8, £ > .05) but scores between conditions for the handicapped students were significantly higher (~ = 3.274, df = 8, £ < .01) for the experimental group. One explanation may be that the handicapped experimental group had greater aptitude than the handicapped control group; mean scores for Part A were not reported so this remains in question. However, all subjects were selected for a normal intelligence range, IQ scores being 96 to 130, so that the low scores of the handicapped control group are not likely to be attributable to low ability level. The mean scores of the different groups are interesting. Means for the the experimental handicapped and the experimental and control nonhandicapped groups were 30.4, 30.4 and 29.6, respectively. The control handicapped group mean was 21.8. Despite the small number of subjects, the implication is that the rest break increased the comparability of handicapped to nonhandicapped persons' mean test performance without significantly affecting nonhandicapped persons' mean performance. The evidence supporting the premise that the adjustment of time limits has little effect on the psychometric characteristics of a power test is slightly more conclusive. Birch, Tisdall, Peabody and Sterrett (1966) administered the Stanford Achievement Test to 293 nonhandicapped 5th grade students, 239 nonhandicapped 6th grade students and 214 partially sighted 6th grade students. When the standard time limit was called, the students were asked to mark the test booklet to indicate the last item they had attempted. They were then given time to complete the test. An analysis of the raw scores showed no significant difference between timed and untimed performance in the nonhandicapped students but an increase significant at the .01 level from timed raw score to untimed raw score in the partially sighted group. The fact that during most of the test, both groups were working under time limits confuses the data to the extent that the "untimed" condition was not truly without time limits but the lack of significant difference in the scores of the 4 nonhandicapped lends support to the idea that untimed administration gives a true assessment of the abilities of handicapped persons while giving no advantage to a standard population. Though neither of these studies describes the effects of the modifications used on the variance, score distributions or test reliability, some indication of the interaction of these variables is given by Nunnally (1967) in a discussion on time limits for power tests. Though there is only a loose relationship between the mean score and reliability, significant changes in the standard deviation and score distribution can have important effects on the reliability of a test. In general, the greater the standard deviation, the greater the test reliability. The shape of the score distribution gives an indication of the reliability of the test at various score levels. Several researchers have addressed the concern that test modifications such as oral administration or pantomime may significantly alter the measurement of the target factor (Holden, 1951; Jewell &Wursten, 1951; Kaufman, 1966; Reynell, 1970; Sapinkopf, 1978; Schlenoff, 1977). It is important to note here that selection instruments are usually tests of mental abilities (though some are intended to measure speed of performance) and it is usually hoped that an individual's test score will directly reflect that person's level of ability (Nunnally, 1967). It is evident that the administration of an ability test to a motor handicapped individual under timed conditions or without other modifications needed by that individual will certainly reflect the interference of the motor handicap thus altering the factor composition of the score. Although some modifications of examining procedures affect to a certain extent the factor composition of test scores there can be little doubt that without such modifications, when they are necessary, no fair assessment of a motor handicapped person's mental abilities can occur.4 Examining Procedures This section provides suggestions for the modification of examining procedures Prior experience of Commission test development staff has shown that the number of personswho elect to take a test modified for a particular motor handicap is inadequate for reliable studies of changes in factor composition due to the modifications, hence there will probablybe very few studies of this problem reported.in the future. 7 which will tend to reduce the physical barriers encountered by many motor handicapped individuals in a testing situation. The complications presented by the varying types of handicaps and the degrees of impairment found within each type limit the· amount of specificity possible in relating a certain modification to a certain diagnostic category of motor handicap. Therefore, these guidelines have been organized around general levels of functional capacity with specific recommendations grouped under these levels. Pretest Considerations Initial ~ontact. When an applicant has identified him or herself as handicapped, the examining office should contact that person by phone or letter or determine what modifications·, if any, may be required. 5 Additional information such as what modifications the applicant has used in previous testing situations and what modifications are available for the examination can be exchanged at this time. Any reasonable request the applicant may have should be accommodated, if possible. The establishment of rapport between the examiner and the applicant is frequently referred to in the testing literature. Desirable examiner characteristics are patience, calmness, adaptability and tact. Eye-contact, emphasis on ability as opposed to disability and acceptance of handicapped persons as independent, fully-functioning individuals are important interpersonal factors stressed by many authors when dealing with handicapped persons in any situation. Scheduling. An examination which allows 3-5 hours for a nonhandicapped applicant may require up to two days time for administration to an applicant who tires very easily or whose upper body functioning is quite limited. The examiner may choose to allow for this possibility or may consult the applicant to determine whether this much time will be necessary. If no restaurant facilities are available in the building, the applicant should be notified in advance so that lunch arrangements can be made. The test room itself should be quiet and free from distractions as well as comfortable and well-lighted. 5In questionable circumstances the examiner may petent medical authority attesting to the need Some older buildings may be virutally inaccessible to some handicapped applicants. The following informaLion is given to call attention to architectural barriers which must be considered in scheduling the examina tion location. Further information may be obtained from the Guide for Federal Agency Coordinators in Selective Placement of the Handicapped: Identifying and Eliminating Architectural Barriers (1974). If all entrances to the building require a step up or step down or the climbing of stairs, the applicant should be notified so that arrangements can be made for assistance if needed. Adequate clearance should be allowed in corridors and doorways and between desks for the passage of a wheelchair. Approximate dimensions of a hand operated wheelchair are 42 inches long and 27 inches high. Power operated wheelchairs can be as much as 30 inches wide. Turning space required is a 60 inch square or a 63 by 56 inch rectangle; in a corridor, a 54 inch width permits turning. The writing surface provided should have adequate height (under surface 29 inches above floor), width (28 inches) and depth (20 inches behind front edge). The washroom should have at least one toilet stall which is at least five feet by five feet, has a 32 inch door which swings outward and has handrails on each side 33 inches high and parallel to the floor. If the building regularly used for examining presents many obstacles to an applicant due to architectural barriers, serious consideration should be given to scheduling the test elsewhere in a barrier free environment. Federal employment testing and selection procedures used by Federal contractors and recipients of Federal grants or other forms of aid are subject to the Architectural Barriers Act of 1968 and the Rehabilitation Act of 1973 v:hich prohibit discrimination on the basis of facility inaccessibility (see Appendix A). Suitability of untimed administration. The examiner should be aware that some test parts are inappropriate for untimed admin istration. As mentioned on page 6, untimed administration will not significantly alter the psychometric properties of a test to the extent that it is a power test. However, consider requ1r1ng a certificate from a com for·special testing procedures. 8 tests of speed are meaningless without the standard time limits. A power test is designed to measure an individual's level of ability in relation to some mental factor such as reading compre hension, reasoning or mathematical ability. The items assembled for such a test will range in difficulty so that some will be answered correctly by most of the applicants used and others may be solved by· less than a third of them.6 Time limits are usually set so that about 90% of the applicants have time to attempt each item (Nunnally, 1967). (Time limits are set for power tests to ease administration and prevent a skewed distribu tion of working times. This skewed distri bution is caused by the fact that a small percentage of the standard population will typically want to work twice as long as the rest.) The range of difficulty of the items in a pure power test means that, as long as enough time is given, extra time will not affect the level of ability reflected in an individual's score. A speed test is made up of items which are so easy that, given enough time, 95% or more of the applicants would answer all of them correctly (Nunnally, 1967). Time limits for these tests are usually set so that only about 50% of the applicants are able to attempt every item. Tests of typing speed or clerical checking, usually referred to as performance tests, fall under this category and should be omitted for persons whose arm-hand use is limited. However, any decision to omit a test part should be made by a trained testing expert and based on job-related considerations. Recommendations for Modification of Examin ing Procedures No upper body limitation. Applicants who retain full use of the upper body but who still require separate examining should require no test modification. However, it is recommended that the examiner allow a 15 minute rest break between test parts. This is especially desirable for wheelchair-bound applicants who may need frequent, mild exercise to prevent pain, stiffness or undue fatigue. Some power tests may have all items at the same Inability to sit for long periods of time. Postural defects or rheumatic or arthritic diseases may cause great discom fort in a situation requiring long periods of sitting. In addition to allowing rest breaks between test parts, it is advisable to provide a raised table, counter or lec tern and a high stool at which the applicant may sit or stand while taking the test. The examiner should also allow the applicant to change positions as needed. Mild upper body limitations. Appli cants whose ability to use their arms or hands is mildly impaired should be given un limited time for test parts requiring figur ing or writing such as computation or tabu lar completion. A reasonable indicator of degree of impairment would be the person's ability to write: legible though slow hand writing would indicate mild impairment. Rest breaks are recommended and the applicant may choose to mark answers in the test booklet. The examiner can then transfer indicated responses to the answer sheet after the ex amination. A typewriter or other writing aid may be used and the examiner should provide a quantity of blank paper for figuring (the paper should be retained with the test book let at the end of the examining session). Allowance should be made in scheduling for a lunch break if there is a possibility that total examining time will exceed four or five hours. Moderate to severe upper body limitation. An applicant whose impairment is such that writing is completely impractical may require assistance with turning pages and marking the answer sheet. As suggested above, the examiner may wish to have the applicant mark the test booklet itself (ball-point and felt tip pens which may be easier to write with should be provided as well as pencils) and to fill in the answer sheets for the applicant during rest breaks or after the examination. The applicant may prefer to have the examiner do all of the writing. 7 Untimed administration for all test parts which do not specifically test speed (see page 9) is recommended. Use of the type of desk which has the chair attached should be avoided: separate desk and chair will allow the applicant to adjust his or her body position as needed. difficulty level. 7Federal selection tests must be administered by an employee of the Federal government. Other employers may consider allowing a motor handicapped applicant to bring an amanuensis (i.e., someone to do the writing) with whom he or she is accustomed to working. 9 Language disorders. The establishment of two-way communication is the primary consideration in examining applicants who have language disorders. Though some of the following suggestions were developed from work with severely handicapped individuals, they may prove helpful in the examining of applicants whose neuromuscular impairments also present moderate barriers to communication. More detailed information is available in Reynell (1970), Allen (1958) and Allen and Collins (1955). Examiner to applicant. The manner of presentation of test instructions to a person who has a receptive disorder (e.g., an agnosia) will depend on the applicant's capabilities. Before the examination, the examiner should determine the applicant's preferences, whether oral or written, and be prepared accordingly. Where there is a visual problem but no hearing disorder, oral administration can be used. There may be hearing problems but little or no visual problem in which case written instructions: in large pr:int or clear handprinting may be appropriate. If the disorder is severe, it may be necessary to use pantomime, gestures and/or pointing to supplement the oral or written instructions. Applicant to examiner. Indication of the desired response may be accomplished in writing, by pointing or through a system of signals but, as above, the applicant's preferences should determine the procedure used and must be established before the examination. If the applicant's motor coordination precludes marking the desired response on the answer sheet or in the test booklet, he or she may choose to use ·a typewriter or to write on a larger sheet of blank paper. Pointing to the response may be possible, especially if large print test materials are available. A system of signals can be established where there is severe disability using any movement or vocalization the applicant can reliably perform. (For instance, a nod might signify "A," a blink might indicate "B," etc.) Use of this procedure requires very careful observation and before the test there should be a practice session during which the examiner can determine exactly what constitutes an indicated response. Presentation of test materials. A person who has a language disorder will usually prefer one channel of communication, written or oral, over the other but this preference may depend on the type of material being presented. If available, it would be most advantageous to allow a choice of media (regular print, large print, tape or readerS) and allow the applicant to change from one to another depending on the type of material (i.e., math problems vs. reading comprehension). For some applicants whose overall disability is severe, the use of two media at once (dual presentation)" may be helpful. If the applicant's vision is limited by involuntary or incoordinate eye movements, it may be advisable to present individual items separately on 5" by 8" cards. An alternative arrangement is the use of a card with a slit cut in the center in such a way that the applicant can see only one group of words at a time. NOTE: The U.S. Civil Service Commission has an active research and development program concerned with the modification of tests for use with applicants for Federal employment who are visually impaired, deaf or motor handicapped. For further information on this program, please contact: Mary Anne Nester, Project Director Test Services Section Personnel Research and Development Center U.S. Civil Service Commission Washington, D.C~ 20415 Questions on the special use of Federal tests for handicapped applicants should be addressed to: Herbert Ozur Applied Psychology Section Personnel Research and Development Center U.S. Civil Service Commission Washington, D.C. 20415 See Appendix B for instructions to readers for visually handicapped applicants. 10 Other PRDC publications on testing the handicapped include: Munoz-Colberg, M. and Nester, M. A. A logic-based approach to the measurement of deductive abilities in deaf and hearing persons. Manuscript submitted for publication, 1978. Nester, M. A. Use of the Cranmer abacus by blind persons (PS 74-2). Washington, D.C.: Personnel Research and Development Center, United States Civil Service Commission, October 1974. (NTIS No. PB 258 205) Sapinkopf, R. C. Statistical characteristics of the written test for the Professional and Administrative Career Examination (PACE) for visually handicapped applicants (TM 78-1). Washington, D.C.: Personnel Research and Development Center, United States Civil Service Commission, January 1978. (NTIS No. PB 280 491) van Rijn, P. P. Testing the handicapped for employment purposes: Adaptations for persons with dyslexia (TM 76-4). Washington, D.C.: Personnel Research and Development Center, United States Civil Service Commission, March 1976. (NTIS No. PB 261 .697) REFERENCES Allen, R. M. Suggestions for the adaptive administration of intelligence tests for those with cerebral palsy: Part II. Cerebral Palsy Review, 1958, ~. 6-7. Allen, R. M., & Collins, M. G. Suggestions for the adaptive administration of intelligence tests for those with cerebral palsy: Part I. Cerebral Palsy Review, 1955, 16, 11-14, 25. Anastasi, A. Psychological testing (4th ed.). New York: MacMillan Co., 1976. Angel, J. L. Employment opportunities for the handicapped. New York: World Trade Academy Press, Inc., 1969. 11 Bice, H. V. Psychological examination of the cerebral palsied. Journal of Ex ceptional Children, 1948, 14, 163-168. Birch, J. W., Tisdall, W. J., Peabody, R., & Sterrett, R. · School achievement and effect of type size on reading in visually handicapped children (Cooperative Research Project No. 1766). Washington, D.C.: Cooperative Research Program, Office of Education, Department of Health, Education and Welfare, .1966 . Blonsky, E. R. The changing picture of parkinsonism: Part I. Neurological modifications resulting from adminis tration of L-dopa. Rehabilitation Literature, 1971, ~. 34-37. Boone, D. R. Communication skills and in telligence in right and left hemi plegics. Journal of Speech and Hear ing Disorders, 1959, ~. 241-248. Coleman, H. M;, & Dawson, S. T. Educational evaluation and visual-perceptual-motor dysfunction. Journal of Learning Disabilities, 1969, 1. 242-251. Connor, F. P. The education of children with crippling and chronic medical conditions. In W. M. Cruickshank &G. 0. Johnson (Eds.), Education of exceptional children and youth (2nd ed.). Englewood Cliffs, N.J.: Prentice-Hall, 1967. Cull, J. G., &Hardy, R. E. Correlation be tween the immediate test and the Wechsler Adult Intelligence Scale Verbal Scale in the rehabilitation setting. The Journal of Psychology, 1971, 12· 203-205. Denhoff, E., & Robinault, I. P. Cerebral palsy and related disorders. New York: McGraw-Hill Book Co., Inc., 1960. Diller, L. Hemiplegia. In J. F. Garrett & E. S. Levine, Psychological practices with the physically disabled. New York: Columbia University Press, 1962. Doll, E. A. Mental evaluation of children with expressive handicaps. American Journal of Orthopsychiatry, 1951, 1!, 148-154. Dudley, J. G., Doehring, D. G., & Coderre, L. Speed of visual perception in aphasic and non-aphasic patients with hemiplegia. Cortex, 1969, ~. 389-402. Fair, D. T., & Birch, 0. W. Effect of rest on test scores of physically handicapped and non-handicapped children. Exceptional Children, 1971, ~. 335-336. Garron, D. C., Klawans, H. L., & Narin, F. Intellectual functioning of persons with idiopathic parkinsonism. The Journal of Nervous and Mental Disease, 1972, 154, 445-452. Glick, S. J., & Donne!, C. Non-medical problems of the adult with cerebral palsy. Nursing Outlook, 1953, !, 277-279. Goldberg, J. K. The opthalmologist looks at the reading problew. American Journal of Ophthalmology, 1960, iL, 67. Greenbaum, M., Quatere, T., Carruth, B., & Cruckshank, W. Evaluation of a modification of the Thematic Aperception Test for use with physically handicapped children. Journal of Clinical Psychology, 1953, 1, 40-44. Haber, L. D. Disabling effects of chronic disease and impairment--IT. Functional capacity limitations. Journal of Chronic Diseases, 1973, 26, 127-151. Hewett, F. M. Education of exceptional learners. Boston: Allyn & Bacon, Inc., 1974. Holden, R. H. Improved methods in testing cerebral palsied children. American Journal of Mental Deficiency, 1951, 56, 349-353. Hollander, J. L. (Ed.). Arthritis and allied conditions. Philadelphia: Lea & Festinger, 1966. Jewell, B. T., & Wursten, H. Observations on the psychological testing of cerebral palsied children. American Journal of Mental Deficiency, 1951, ~. 630-637: Jones, M. H., Dayton, G. 0., Bernstein, K. L., Strommen, E. A., Osborne, M., &Watanabe, K. Pilot study of reading problems in cerebral palsied adults. Developmental Medicine and Child Neurology, 1966, ~. 417-427. Kaufman, A. An oral digit-symbol test. Journal of Clinical Psychology, 1966, 11_, 180-183. Levita, E., & Riklan, M. On subcortical correlates of verbal functions in parkinsonism: Critical considerations. The Journal of General Psychology, 1973, ~. 3-9. Linde, T., & Patterson, C. H. The MMPI in cerebral palsy. Journal of Consulting Psychology, 1958, 22, 210-212. Mase, D. J., &Williams, C. F. The assessment of college experience of severely handicapped individuals. Gainesville, Fla.: College of Health Related Services, University of Florida, 1962. Muscular Dystrophy Association. MDA services to the patient, the family, the community (PlOS 200M 2/77). New York: Muscular Dystrophy Association, 1977. Muthard, J. E., & Hutchison, J. Cerebral palsied college students, their education and employment. Gainesville, Fla.: University of Florida Press, 1968. Nester, M. A. Use of the Cranmer abacus by blind persons (PS 74-2). Washington, D.C.: .Personnel Research and Development Center, United States Civil Service Commission, October 1974. (NTIS No. PB 258 205) Nunnally, J. C. Psychometric theory. New York: McGraw-Hill Book Co., 1967. Ogg, E. Milestones in muscle disease research (Pl90-500M-871). New York: Muscular Dystrophy Associations of America, Inc., August 1971. Reynell, J. Children with physical handicaps. In P. Mittler (Ed.) The psychological assessment of mental and physical handicaps. London, England: Methuen, 1970. Roeher, G. A. Significance of public attitudes in the rehabilitation of the disabled. Rehabilitation Literature, 1961, 11_, 66-72. 12 Sapinkopf, R. C. Statistical characteris van Rijn, P. P. Testing the handicapped for tics of the written test for the employment purposes: Adaptations forProfessional and Administrative persons with dyslexia (PS 76-4). Career Examination (PACE) for visually Washington, D.C.: Personnel Researchhandicapped applicants (TM 78-1). and Development Center, United StatesWashington, D.C.: Personnel Research Civil Service Commission, March 1976. and Development Center, United States (NTIS No. PB 261 697) Civil Service Commission, January 1978. (NTIS No. PB 280 491) Venardos, M.G., & Harris, M. B. Reducingtest anxiety in a clinical population:Schlenoff, D. Considerations in administer A comparison of relaxation training, ing intelligence tests to the physicaltest orientation and a therapeuticly disabled. Rehabilitation Litera interview. Rehabilitation Counselingture, 1974, 35, 362-363. Bulletin, 1973, ~. 137-145. Schlenoff, D..Psychosocial characteristics Wachs, T. D. Personality testing of therelated to employment status of quadrihandicapped: A review. Journal of plegics. Unpublished doctoral disserta Projective Techniques and Personality tion, The George Washington University, Assessment, 1966, 30, 339-355.September 1977. Warburton, J. W. Memory disturbance and the Schantz, F. C. Evaluation of intellectual Parkinson syndrome. British Journalpotential in hemiplegic individuals. of Medicine and Psychology, 1967, 40,Journal of Clinical Psychology, 1957, 169-171.13' 26 7-269. Wepman, J. M. The language disorders. InSterne, D. M. The Knox Cubes as a test of J. F. Garrett & E. S. Levine Psycholo memory and intelligence with male gical practices with the physicallyadults. Journal of Clinical Psydisabled. New York: Columbia Univerchology, 1966, 1l• 191-193. sity Press, 1962. United States Civil Service Commission.Guide for Federal agency coordinatorsin selective placement of the handicapped; identifying and eliminatingarchitectural barriers (BRE-60).Washington, D.C.: Bureau of Recruiting and Examining, 1974. 13 APPENDIX A THE ARCHITECTURAL BARRIERS ACT OF 1968 (PL 90-480) AN ACT To insure that certain buildings financed with Federal funds are so designed and constructed as to be accessible to the physically handicapped. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That, as used in this Act, the term "building" means any building or facility (other than (A) a privately owned residential structure and (B) any building or facility on a military installation designed and constructed primarily for use by able bodied military personnel) the intended use for which either will require that such building or facility be accessible to the public, or may' result in the employment or residence therein of physically handicapped persons, which building or facility is- (1) to be constructed or altered by or on behalf of the United States; (2) to be leased in whole or in part by the United States after the date of enactment of this Act after construction or alteration in accordance with plans and specifications of the United States; or (3) to be financed in whole or in part by a grant or a loan made by the United States after the date of enactment of this Act if such building or facility is subject to standards for design, construction, or alteration issued under authority of the law authorizing such grant or loan. 14 APPENDIX B INSTRUCTIONS TO READERS FOR VISUALLY HANDICAPPED APPLICANTS Study these instructions before you go to the exarn1n1ng room; study them until you are sure that you will not overlook any part of them. As will be apparent, you can assist only one applicant at a time. No friend who comes with an applicant may be permitted to listen to the examination. Directions. Give the applicant the information in the directions in a friendly manner, repeating parts as often as necessary until you are sure he or she understands them. Test questions. In reading the test questions be especially careful to observe the following cautions: 1. Read each question and its alternatives as clearly as you can. Give special emphasis to words printed in italics or capitals and tell the applicant that they are printed that way. 2. Avoid .trying to find the correct answer to any question as you read it, because you might unconsciously pause or speak with a change of inflection when you find the answer. 3. Be particularly careful to give equal stress to each alternative, reading all before waiting for a response. 4. If the applicant designates the answer by letter only (D, for example), ask if he or she wants you to reread the complete alternative before marking it on the answer sheet. 5. If the applicant chooses an answer before you have read all five alternatives, ask if he or she wants you to read the rest of the alternatives before marking the answer sheet. 6. Whenever the applicant pauses for any considerable time after you have read the last alternative of a question, say: Do you want me to read that again? Or any part of it? In rereading questions be especially careful that you avoid g1v1ng any special emphasis to the words that you think are most important, unless those words are printed in italics or capitals. <> U. S. GOVERNMENT PRINTING OFFICE, 1978-620-003/3303 15