In response to concerns raised about the ethics about coaching or teaching the test on websites in which psychologists coach people on taking the MMPI-2, one particular website addressed the matter of being able to read and understand the questions on the MMPI-2 in English.
The following two items that pertain to the ability to read and comprehend English MMPI-2 items violate proper test administration when there are language and cultural barriers (goes to competent, valid, and ethical multilingual assessment):
- If you cannot, you need to have someone interpret each statement to you so you understand each statement.
- If English is your second language, unless you read and understand English well, you should have someone translate the items to you in your native or primary language.
It is inappropriate to use interpreters to spontaneously translate test questions from English to Spanish, not to mention the use of informally translated tests. Even with tests that have been professionally prepared, questions are raised about their validity with the target population when it is different from the population upon which norms were obtained.
Other difficulties emerge as well. Consider, for instance, the MoCA (Montreal Cognitive Assessment) which was designed as a brief screening test for mild cognitive dysfunction. One of the Language Tests, Sentence Repetition, consists of repeating two sentences. These are:
- I only know that John is the one to help today. (11 words)
- The cat always hid under the couch when dogs were in the room. (13 words)
Total # of words: 24 words; average length per sentence: 12 words.
- El gato se esconde bajo el sofá cuando los perros entran en la sala. (14 words)
- Espero que él le entregue el mensaje una vez que ella se lo pida. (14 words)
Total # of words: 28 words; average length per sentence: 14 words
Aside from sentence length, note that the first English sentence, “I only know that John is the one to help today”, was not translated into Spanish. And in Spanish, “Espero que él le entregue el mensaje una vez que ella se lo pida”, does not exist in the English MoCA. Moreover, the second sentence is not translated accurately. The word “always” disappeared, and “entran en la sala” means “enter the room”, not “were in the room.” And the tense is different: past tense in English; present tense in Spanish. If you add the word “siempre” (always) to the Spanish sentence, and correct the tense, you’d have 15 words: El gato siempre se escondia bajo el sofa cuando los perros entraban en la sala. This would raise the word average per sentence to 14.5 words.
Another example is a popular test known as Digit Span, in which the examinee repeats progressively longer series of numbers forwards and backwards.
Look at the number of vowels in the numbers 0 to 9 in English, and their counterparts in Spanish:
One = one syllable; Uno = two syllables
Two = one; Dos = one
Three = one; Tres = one
Four = one; Cua-tro = two
Five = one; Cin-co = two
Six = one; Seis = one
Se-ven = two; Sie-te = two
Eight = one; O-cho = two
Nine = one; Nue-ve = two
Ze-ro = two; C-ero = two
As can be seen, 5 of 10 numbers have more syllables in Spanish.
Now, repeat: 1-4-5-8-9 in English and Spanish:
English: One-four-five-eight-nine = 5 syllables
Spanish: U-no-cua-tro-cin-co-o-cho-nue-ve = 10 syllables
A question to ponder: as a hypothetical, is this single item equivalent in both languages as a measure of working memory?
Culturally competent assessment requires paying close attention to culture, language, normative data, and how the norms were obtained. Existing tools, therefore, may not be valid for the intended target populations.