Articles: Nation’s largest children’s behavioral health center opens &
When to update to the newest revision of a test Below}

Nation’s largest children’s behavioral health center opens

By Chuck Nelson, Associate Editor

April 18, 2020

The Big Lots Behavioral Health Pavilion, billed as the largest behavioral health treatment and research center on a pediatric campus in the United States, has opened on the Nationwide Children’s Hospital grounds in Columbus, Ohio.

Its medical director hopes it will set an example for future projects.

“Our ability to share our care model with other providers across the country will establish Nationwide Children’s at the forefront of solving our mental health crisis,” said David Axelson, MD, chief of psychiatry for Nationwide Children’s and medical director of the new facility.

The nine-story, 386,000-square-foot building is dedicated to children and adolescents with behavioral health conditions. It’s part of a $730 million campus expansion Nationwide Children’s announced in 2016 and marks the first time the hospital has had a free-standing facility for patients with mental health issues.

Columbus-based discount retailer Big Lots and its foundation provided $50 million toward the $159 million cost of the facility.

“Children’s mental health is just as important as their physical health, and the Big Lots Behavioral Health Pavilion emphasizes the hospital’s commitment to that balance as part of caring for the whole child,” said Tim Robinson, chief executive officer of Nationwide Children’s. “This unique facility will help youth in crisis, but our care extends beyond its walls. We are focused on education and advocacy to transform children’s mental health.”

About half of the floors were to be finished by the building’s opening on March 10. Some of the space has been left empty to allow for future growth and some will remain empty for a time because the hospital can’t find enough medical workers, Axelson told The Columbus Dispatch.

A Pediatric Acute Care psychology team will staff the new facility, said Eric Butter, Ph.D., chief of psychology for Nationwide Children’s. The team consists of three psychologists, two psychology post-doctoral fellows and one pre-professional psychology intern. Another psychologist will work in the Mood and Anxiety Intensive Outpatient Service.

“The psychologists working in Acute Care Services are helping to develop clinical programming, including group and individual treatment services using evidence-based practices,” Butter said. “These psychologists are highly involved in supporting the training of our nursing staff and mental-health technicians working in the hospital.

“Our psychologists are also helping to design patient and parent education materials to support their inpatient stays.

“We have also developed psychology training programs at the fellowship and internship

level to help prepare future psychologists for this kind of career, both here at

Nationwide Children’s and at other children’s hospitals across the country.”

Nationwide Children’s has nearly 100 psychologists in its system, he said.

The facility includes a Psychiatric Crisis Department on the first floor with nine assessment rooms and 10 extended observation rooms with beds and safe restrooms for stays of up to 24 hours. Some of the rooms are padded. There also is a critical assessment and treatment clinic on the floor.

A youth crisis stabilization unit with 12 beds on the second floor is designed for intensive mental health treatment for youth.

Inpatient units on the seventh and eighth floors have classrooms and group gathering areas where patients can keep up on schoolwork. These floors also have “porches” — enclosed areas with access to light and fresh air.

Each patient room has a built-in L-shaped bed, color-changing lighting, foam bathroom doors for privacy and televisions with age-appropriate programming. The doors to the rooms have special frames to prevent patients from barricading themselves inside.

The inpatient floors initially will offer 22 beds, but that number will increase to 48 overtime.

Calming paint colors, soft surfaces and adjustable lighting are found throughout the building. Waiting areas are outfitted with heavy, comfortable chairs that can’t be easily moved.

There also are comfort rooms throughout the building to offer soothing spaces.

Other areas in the building house a mood and anxiety program, family-based intensive therapy, an outpatient psychiatry clinic, a 3,000-square-foot gym and a multi-functional outdoor play deck.
There’s also a Ronald McDonald family room, a sanctuary and outdoor courtyards to provide space for families to relax.

Before the new facility was built, treatment for youngsters with mental health issues was scattered around the hospital complex and those in crisis were treated in the main hospital emergency room. The hospital had 16 inpatient beds.

When to update to the newest revision of a test

By Daniella Maglione, Ed.S., MS, Gail Rodin, Ph.D., and Maggie Kjer, Ph.D.
April 18, 2020

In our work for a major psychological test publisher, one of the questions we’re asked most frequently is, “When do I need to transition to the latest revision of a test?”

Our employer and - to the best of my knowledge - no other major

test publisher makes any recommendation with regard to this question.

Instead, publishers urge test users to look for guidance from their professional associations, most frequently the American Psychological Association (APA) and the National Association of School Psychologists (NASP).

What information do these and other organizations provide on the topic?

APA’s Ethical Principles of Psychologists and Code of Conduct offers the following guidelines:

9.08 Obsolete Tests and Outdated Test Results
(a) Psychologists do not base their assessment or intervention decisions or recommendations on data or test results that are outdated for the current purpose.
(b) Psychologists do not base such decisions or recommendations on tests and measures that are obsolete and not useful for the current purpose.

The NASP Principles for Professional Ethics also states that when utilizing norm-referenced measures, school psychologists should, “choose instruments with up-to-date information.”

Some additional justification for this advice is provided in NASP Best Practices in School Psychology IV, Volume 2 (2002), which says:

“The newest revision and most recent norms for a test should be used because recent studies show that the stringency of norms changes over time and more recent norms typically are tougher than older norms. The now well-known Flynn Effect must be considered to avoid the undue effects of out-of-date norms.”

James R. Flynn, a New Zealand researcher on intelligence, concluded after examining the intellectual level of the U.S. population for 46 years that the average annual national gain is .33 IQ points. This indicates that in a 10-year time span, IQ scores should differ by approximately 3 IQ points.

Finally, the American Educational Research Association (AERA) Standards for Educational and Psychological Testing (2014) say:

“Test specifications should be amended or revised when new research data, significant changes in the domain represented, or newly recommended conditions of test use may reduce the validity of test score interpretations. Although a test that remains useful need not be withdrawn or revised simply because of the passage of time, test developers and test publishers are responsible for monitoring changing conditions and for amending, revising, or withdrawing the test as indicated.” Standard 4.24 (under Standards for Test Revision)

The comment for the above AERA Standard adds:

“Test developers need to consider a number of factors that may warrant the revision of

a test, including outdated test content and language, new evidence of relationships

among measured or predicted constructs, or changes to test frameworks to reflect

changes in curriculum, instruction, or job requirements. If an older version of a test is

used when a newer version has been published or made available, test users are

responsible for providing evidence that the older version is as appropriate as the new

version for that particular test use.”

While all of these professional resources are in agreement regarding the importance of, and reasons for, using the most up-to-date test measures, none specifies a time frame for compliance. In the absence of

any clear rule regarding transition time, a professional consensus (sometimes referred to as a “community standard”) has solidified, suggesting that the switch should be made within one year of publication. An article titled “Ethical Standards and Best Practices in Using Newly Revised Tests” by Stefan Dombrowski states:

“The profession has instead established a community standard for the transition to newly revised IQ instruments: Ranging from six months to one year, this transition period has been tacitly agreed upon by trainers of school psychologists and other leaders in the field.”

There is also a lack of consensus in terms of states’ special education regulations. Some states allow for a one-year transition period while others do not address the issue.

For example, the Florida Department of Education does not have a written policy specifying the timeline for transitioning to a new revision of an instrument. However, districts typically utilize one year as a timeline, which they believe (erroneously) to conform to test publishers’ recommendations.

While there is a dearth of published ethical or legal guidance for psychologists on the question of when we “must” switch to the most recent revision of a test, there is evidence of an “unspoken rule” when one looks at legal decisions regarding the use of assessment for the purpose of special education eligibility determination and placement.

Hearing officers from several states have invalidated evaluations because the psychologist utilized an outdated version of a test, including an important decision affecting the Boston Public School System.

Similarly, a colleague who is a member of her state’s psychology licensing board noted that in her experience, “If a school district has a litigious client population (i.e., increased risk of ending up in a due process hearing), their assessments will be more ‘legally defensible’ if they have utilized the most current version of the tests.”

In summary, one must look closely at the various relevant ethical guidelines and best practices provided by professional organizations, as well as state guidelines, in order to make an informed decision regarding when to upgrade to a new revision of a test.

Ultimately, it is our responsibility as professionals to make this decision, in order to assure that our test results are accurate and to maximize the likelihood that they will contribute to the most appropriate diagnostic and treatment decisions for the clients we serve.

References available from authors

The authors are solutions analysts for Pearson. Daniella Maglione, Ed.S., MS, is a Florida licensed school psychologist and certified school psychologist. She specializes in national licensing models for Pearson. Her email address is: Daniella.Maglione@pearson.com. Gail Rodin, Ph.D., is a licensed psychologist and health services provider in psychology (HSP-P) in North Carolina. Her email address is: Gail.Rodin@Pearson.com. Maggie Kjer, Ph.D., is a certified director of special education specializing in emotional and behavioral disorder program development.