September 04, 2014 Articles

Three's a Crowd: The Impact of Third-Party Observers on Neuropsychological Exams

By Matthew R. Shindell, Robert J. McCaffrey, and Graham M. Silk-Eglit

Attorneys frequently request to observe or record neuropsychological examinations of their clients or other parties in litigation. Admission of a third party to the neuropsychological evaluation, however, raises several problems—all of which can significantly affect how, or whether, such an exam holds up in court. A wealth of research shows that third-party observation can affect the performance of examinees on an array of cognitive and motor tasks that are typically administered during neuropsychological examinations. Moreover, admission of third-party observers may violate ethical guidelines governing clinical and forensic neuropsychological practice. While federal courts generally prohibit third-party observers from being present during psychiatric, psychological, and neuropsychological evaluations, state courts have established differing rules regarding their permissibility.

This article examines research on the effect of third-party observers on task performance, outlines the ethical issues third-party observation presents to neuropsychologists, and discusses state court rulings on the presence of third-party observers in psychological, neuropsychological, and independent medical exams.

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