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Attaining expert opinions for clients with possible cognitive impairments
One neuropsychologist outlines how lawyers can attain the most accurate and valid expert opinion for a client who may qualify for a cognitive impairment.
Jess Feyder
Recently, on the Lawyers Weekly Show, author and neuropsychologist Dr Hannah Korrel discussed how lawyers can best utilise the expertise of neuropsychologists when building a case and outlined some knowledge on the topic that lawyers should develop.
There are a lot of cases where a lawyer is representing a client, or defending against a client, who has a cognitive issue that has been diagnosed or outlined, and the lawyer needs to figure out the impact of those cognitive abilities on their ability to testify, to make decisions, or to be responsible for their choices, Ms Korrel explained.
Ms Korrel outlined the steps lawyers should take to ensure they collect the information they need to best serve their clients.
Identifying the right expert
Different specialists in the field of psychology have different qualifications and capabilities in assessing cognition, even though all are legally allowed to do psychometric testing, Ms Korrel explained.
However, she said, the most trained professionals on the matter are neuropsychologists.
If deciding to get an IQ assessment from any other kind of psychologist, it would be important to assess their experience, she advised.
Even though neuropsychologists are most trained, other practitioners may be capable of making even better assessments, such as those with significant experience in the specific cognitive impairment one is looking into, for example, intellectual disabilities or autism, Ms Korrel outlined.
Clarity in the request
“When I get a referral from a forensic setting or a legal setting, what I need is a professional referral written up from a lawyer to say exactly what they are after,” Ms Korrel explained.
“What are the exact questions that you want an answer to, and in what way do you want that answer?
“Is it a yes [or] no? Yes, Mr X had the capacity to make the decision that he did on the night in question. Or what is Mr X’s IQ? Does he qualify for an intellectual disability? And if he does, at what level does he then no longer have the capacity to make decisions in regard to X, Y, Z?
“Having those very specific questions is really important,” she explained. “It can’t just be a bunch of emails; it’s got to be a proper referral question.”
If you are unsure how to go about it, you can consult with the neuropsychologist before creating the referral, explaining the situation and the outcome you’re looking for, and they can recommend what testing should be done, Ms Korrel illuminated.
Understand what you are testing
“There are many different parts of cognition,” Ms Korrel continued, and in different cases, it might be important to ascertain a particular cognitive ability, or to get a broad understanding of the person, which would mean testing for a wide range of cognitive abilities.
There are cases where lawyers need to find out if their client has issues with executive functions, like impulse control, or the capability to make good, rationalised decisions, or memory function, she explained; it is important to know what specifically you want to find out, so you know what to test.
General knowledge
When Ms Korrel was asked if she would advise lawyers to upskill on neuropsychology, she replied, “a thousand times, yes”.
“Essentially, there are a few key things to understand. Number one — the Wechsler Adult Intelligence Scale number five, and for children, the Wechsler Intelligence Scale for Children, number five.
“Those will tell you IQ,” she explained, “which will help identify if they have an intellectual disability and if it is mild, moderate, or severe”.
To understand memory functioning, there is “the Wechsler Memory Scale number four”, she outlined.
Another key consideration is capacity; does the person have the capacity to make decisions in certain domains, she said.
The last “golden piece of knowledge is severity”, she stated; it is important to understand “how severe the cognitive issue, the injury, the brain injury, or the acquired brain injury is”.
