Use and misuse of norm-referenced tests in clinical assessment: a hypothetical case

The purposes of this paper are to discuss concepts that are fundamental to proper use of norm-referenced tests in clinical assessment, to consider common errors in the use of such tests, and to suggest alternatives to norm-referenced testing for certain assessment purposes. A hypothetical client is used to illustrate the following errors: the use of age-equivalent scores as the sole summary of test results, the use of individual items to formulate therapy objectives, and the failure to consider the possible effects of measurement error when difference scores are used to assess progress or to examine patterns of impairment.