DOPL and Dyslexia

Last week, the Administrative Rules Review Committee met to discuss the Division of Occupational and Professional Licensing‘s assertion that dyslexia can only be assessed and treated by psychologists licensed by the state.

At issue was a complaint made against the Dyslexia Center of Utah, which employs trained specialists who do not have such a license. Should such persons, clearly qualified in their field of work and screened properly by their employer, be barred from providing services to the public without the permission of the state?

More specifically, these employees were helping assess and treat dyslexia by administering the Comprehensive Test of Phonological Processing—a standard test that’s more like a game for the children who take it. It produces a fluency score and offers supplemental tests that help determine whether the child has difficulty with phonological analysis which may indicate dyslexia.

Prior to last week’s meeting, the director of the Dyslexia Center of Utah, Shelley Hatch, sent an email to Dr. Joseph Torgesen, one of the authors of this widely used test. Hatch wanted to ask Torgesen’s thoughts on what qualifications were needed to administer the test. Did he think that licensed psychologists were inherently qualified? Torgesen replied:

I thought the qualifications for those who we think can administer and interpret the CTOPP effectively were spelled out pretty clearly at the beginning of the test manual. I’m in Southern California at the moment, and don’t have the manual in front of me, but I would disagree strongly with the idea that one needs to be a certified school psychologist, or a licensed clinical psychologist to administer, score, and interpret the test. In fact, a lot of school psychologists don’t know enough about the psychology of reading or the relationship between language process and reading to interpret the test effectively. In my view, anyone who can pronounce and discern individual phonemes correctly, who has a basic understanding of the importance of following standardized administration procedures, who understands the meaning of standardized test scores, and who has a grasp of the way phonological processes and knowledge are related to reading skill should be able to administer and interpret the test effectively. To say that only school or licensed psychologists can administer and interpret the test is professional protectionism at its worst.

As is often the case in questions of occupational licensure, it ultimately boils down to economic protectionism, as Torgesen noted. And the determination that licensure is not needed (or useful) was affirmed in this morning’s meeting by Dr. Jerome Schultz, Clinical Neurologist at the Harvard Medical School. Schultz stated:

The question is: can services be provided to students with dyslexia by somebody who is not licensed? Absolutely yes. They can be, and they are currently around the United States.

Schultz also said that, “In my view, you don’t have to be a psychologist to administer tests [to assess whether a child has dyslexia]—especially if you have sufficient training and experience.” What is especially backwards about Utah law is that a licensed psychologist is legally able to administer such tests, despite likely not having any experience or expertise with the actual tests used. But those who are trained and certified by the companies who have created the tests are being threatened by DOPL for their desire to help children whose parents have willingly solicited their services.

These meetings were ultimately held because statute is not clear on this question. DOPL has interpreted the law broadly in their favor, such that those assessing these specific tests (despite their training) are being told that they must have a psychology license. Obtaining such a license requires that the applicant: have a doctoral degree in psychology; have completed 4,000 hours of psychology training over the course of at least two years; pay a fee; and pass an examination administered by DOPL.

If this situation sounds familiar, it’s because it closely mirrors the Jestina Clayton hair braiding case. Clayton was doing a very specific type of hair braiding that reasonable people would presume did not require licensure, but DOPL interpreted the law broadly in its favor and mandated that she obtain a cosmetology license, requiring 2,000 hours of school and a fee in order to simply braid hair for pay. Clayton sued DOPL and won.

“I don’t want to be a psychologist,” said Shelley Hatch of the Dyslexia Center of Utah. “I just want to help a child learn how to read.”

And Utah’s government won’t let her.