67 Transcript

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[00:00:00] Dr. Sharp:  Hello everyone and welcome to The Testing Psychologist podcast episode 67. I am Dr. Jeremy Sharp, excited to be here with you today and excited to share the conversation with Dr. Ed Martinelli. We talk all about testing in the university setting, both in and out.

Dr. Martinelli got his bachelor’s and master’s from Brigham Young University. He then got his Ph.D. from Auburn University, a fact that I will overlook as a South Carolina graduate. It’s neither here nor there. After that, he went on to become the Director of the Disability Office at Utah Valley University, then opened a private practice in 2009 where he focused on providing psychoeducational evaluations to young adults, still thriving to this day.

He has been the director of two other university departments since then, [00:01:00] and has been in his current role as Director of Learning Disability Assessments at Utah Valley for about the past three years. Ed was super friendly, and very personable. He shares a lot of information just about the ins and outs of testing in a university setting.

He gets to share his perspective from the disability office standpoint, as well as the private practice standpoint. So we talk about all sorts of things relevant to that topic. I think you’re going to enjoy it.

Before we jump to the episode, I want to let y’all know about the paperwork packets that I put together for testing services. There’s an administrative packet, there’s a clinical packet, and then there’s a psychometrist training packet for those of you who are interested in hiring folks to do some testing for you. If you want to check those out, go to thetestingpsychologist.com/paperwork. You can get all the information, figure out what forms are in there, and decide if [00:02:00] they’re good for your practice.

All right, onto the episode.

Hey y’all, welcome back to another episode of The Testing Psychologist podcast. I’m Dr. Jeremy Sharp. Today, like you just heard, I have Dr. Ed Martinelli here to speak with us about testing in and out of the university system. We’ll be talking a lot about testing in college environment and how that weaves in with private practice, what universities are looking for, and many pieces of that process.

Ed, a lot of you might recognize, if you’re in the Facebook group, he is very active in the group. That’s where I “met” him. I have [00:03:00] seen a lot of your posts over the past year and a half and they’re always thoughtful, always research-informed, respectful, kind, and I thought, man, I need to reach out to this guy. He seems like he knows a lot and has a lot to share.

So first of all, thanks for coming on the podcast.

Dr. Martinelli: Oh, glad to be here.

Dr. Sharp: I’m so glad to have you. I’m excited for our conversation today. Just by way of a little bit of introduction, you are currently the Director of Learning Disability Assessments at Utah Valley University. You also have a part-time private practice where you specialize in assessment for mainly young adults, is that right?

Dr. Martinelli: Yeah.

Dr. Sharp: Okay. Well, why don’t we open? I would love for you to just take us through the journey of how you got where you are, your training and degree and what your days look like right now.

Dr. Martinelli: I got my [00:04:00] bachelor’s and master’s degrees at Brigham Young University. And then I went and got my PhD at Auburn University in Alabama in the counseling psychology program there. Throughout that training, I had done a lot of assessment courses, really liked that. Was fascinated with the problem-solving and figuring things out. No one was ever really quite the same.

Went on my internship back to BYU and did some assessment things there. I should say, when I was in my PhD program, I did a number a number of my externship or internship practicum sites, once they found out that I had done testing, they were interested in having me do that.

In between my master’s degree and my Ph.D., I spent a year at Utah Valley University, actually back then it was Utah Valley State College doing LD testing on, I think it was a Perkins grant [00:05:00] for about nine months to a year. That’s when I got involved in LD testing kinds of things.

Came back to BYU for internship, after that was hired as the coordinator for psychodiagnostic services in their disability office because BYU is one of the rare universities that does testing for their students and did that for about four years, and then moved over, gave up the testing stuff and became the Director of the Disability Office at Utah Valley University and then decided to open a private practice because of recognizing it was hard for people to get testing done in the college setting.

And then after seven years in that job, moved over here because there was a need for some support for the [00:06:00] testing that was done in the counseling center here at UVU because they have a pretty small staff and trying to do that testing as well was taxing their therapy staff. So they created a position where I could do that solely and that’s morphed into LD testing, ADHD testing, some ADOS testing, pretty much any other kind of assessment things they were hoping to have happen.

Dr. Sharp: Got you. So how much of your time these days is spent clinically versus administratively and other tasks?

Dr. Martinelli: Because I’m just a one-man shop with two APA interns and a clinical psychology extern, the administrative piece, I have maybe five hours that I’m sending out invitations, managing a wait list, reviewing reports, direct supervision, those kinds of things. And then I just try to work with the therapy side. [00:07:00] I run a group with one of the people on the therapy side and see one therapy client, which I think keeps me from completely losing my mind.

Dr. Sharp: I’m with you. That’s funny, I have one therapy client as well.

Dr. Martinelli: I keep my schedule very open around when the students can find testing times. I hear in private practice people who do all-day testing kinds of things and that just doesn’t tend to work for college students, so we do typically 3 or 4 two-hour sessions with students to try to get things done. It Lengthens things out a little bit but I never feel like I’m measuring fatigue. I’m always getting them on the ball.

Dr. Sharp: Yeah, that’s a good point. I know that people have different models around their timeframe for testing. How do you feel like that works in the university setting?

Dr. Martinelli: It works pretty well. [00:08:00] Students tend to enjoy it. They don’t feel like they’re having to interrupt their day. They do at times feel like, man, this is taking forever but sometimes we’ve done three-hour timeframes, that’s nice. That’s about the biggest I can get, but with two hours, you can get through a WAIS, and you can get through a good portion of anything on the Woodcock-Johnson. With three hours, you can knock some things out. That tends to work and then like in my private practice, three-hour timeframes work well because there’s only so much after five o’clock you can do before you as an evaluator are running out of gas.

Dr. Sharp: Absolutely. Tell me a little about the structure of your private practice. It sounds like your job is full time so when does your private practice fit in?

Dr. Martinelli: The [00:09:00] university allows me, like a number of universities do, allows me to use my office after hours and so five o’clock to eight o’clock, two to three nights a week. And then on Saturdays I come in and do something from about nine o’clock to six o’clock, seeing two or three folks.

Dr. Sharp: Oh, goodness. Okay. That’s a lot of time each week. You’re busy.

Dr. Martinelli: It has me busy. The nice thing about it, from my standpoint, is, it’s worked really well with my family’s school things. So like if my son has a concert that he’s going to be at, I can say, I’m not going to test on that day. I can move that around in a way that’s a little easier to meet family obligations as well.

In one of our conversations earlier, I ran up for a scout camp for about a week, and I just said, I’m not going to be seeing anyone and that’s a [00:10:00] little easier to organize than say, a therapy practice.

Dr. Sharp: Sure. I have a lot of questions that I’d like to ask you. I feel like you are in a pretty unique position working in the university but then also having a private practice where you do a lot of similar testing and you’re sending reports to universities as well. So you’ve got a nice perspective from both of those sides to comment on testing with college students and some of those ins and outs. I’m curious, from the private practice side, back when you were getting started, how did you go about that when you had a full-time job? Can you remember how that worked?

Dr. Martinelli: Oh yeah, it burned into my brain. The nice thing was I knew how [00:11:00] to meet all the requirements for the various agent; for folks like Pearson and all the testing companies, getting on how to fill out the forms and get what I needed. As you mentioned in other podcasts, starting to practice, getting the materials; and the cost for that was a big lift of sorts.

The nice thing is because I was confining myself to more college-age students to begin with, getting a WAIS, Woodcock-Johnson battery, looking at some attention measures, MMPI, MCMI, those kinds of things allowed me to keep it pretty narrow and focused as opposed to what [00:12:00] I think other folks I’ve heard and seen do where you’ve got to capture this from like 5 to 50 standpoint, and that can be a little tough.

I think the other piece and it relates to the two sides is more often than not, colleges are not terribly rigid about needing a diagnosis. They really want to get a sense of functional limitation. And that’s how ADA defines disability; is functionally limited in a majored life activity.

There are times when diagnosis for the school wasn’t quite as important as the ability to say, this is where they’re really weak compared to the average person. This is where their strengths are. Often that does lead to say a diagnosis of a specific learning disability but there are times where, I’ll give you a strong example that we see a lot [00:13:00] here in our college in referrals. You’ll get someone who may have a high end of the low average range so somewhere like 85 to 95 IQ, and then their math scores are sitting in the 80’s as well. And they’re, depending on the model you see around specific learning disorders, people might say, well, they don’t meet diagnostic criteria.

I would tend to agree with that, that if you’ve got someone who’s all in the 80’s, they maybe don’t fit borderline intellectual function. They don’t meet intellectual disability criteria but they don’t seem to fit specific learning disorder. But you can write that report saying, look, overall, this student is functional limited in their ability to do math, and for all these reasons, and all this data speaks to that and then speak to recommending an accommodation like a math substitution or other accommodations that might [00:14:00] work for that individual.

I think sometimes we get too hung up on whether you don’t have a diagnosis but the school is looking for that functional limitation and there’s a number of schools that will take that kind of explanation in the report to say, okay, there’s something we can do.

Dr. Sharp: That’s interesting. So you structure the report and you just leave out the diagnostic section or maybe that conclusion sentence that says so and so meets criteria for X diagnosis and just continue on your way and describing functional limitation and recommendation.

Dr. Martinelli: Right. So the conclusion becomes, look, here’s Johnny’s history. Here’s Johnny’s test scores. This is how it all fits together. And then I’ll put a statement in there like, although Johnny doesn’t meet criteria for meeting the diagnostic criteria for a specific learning disorder, he does appear to be functional limited in the area of math, as [00:15:00] evidenced by, and you lay things back out again.

And then in my template, right after conclusion, I have diagnosis, and I may put no diagnosis, and then right under that I have functional limitations, and will say something along the lines of, although Johnny doesn’t meet diagnostic criteria, reiterate, he is functional limited in processing speed, math ability, computational ability, maybe fluid reasoning, those kinds of things.

And then right below that are my recommendations and say, because Johnny doesn’t meet diagnostic criteria but does have functional limitations, these are the recommendations, and then go through a number of those kinds of accommodations that might be typically seen in a college setting.

Dr. Sharp: I got you. As you’re talking, I’m thinking through, so many of our recommendations are driven by diagnostic clarity. [00:16:00] How do you approach that if there’s not a diagnosis necessarily?

Dr. Martinelli: So then I’m looking at just in what way is that student going… let me back up. Under ADA, you’re looking for how to help the student have access to the setting, whereas under IDEA, often it’s about how to have the student be successful. That difference between success and access is an important difference between say the K-12 system and the college system.

So I’m not looking to have the student be successful, I want to make sure that they can have access to the environment. I might have a student who has really low reading scores and phonological processing scores, and I might say, this student, because of what these scores are telling me, they’re going to struggle in being able to access a textbook or be able to take [00:17:00] notes off the board or those kinds of things. I’ve got that backed up by the test data and all the behavioral observations and all those things and say, this then are the accommodations that might help that student be able to access the material.

So even though I may not meet a diagnosis of a specific learning disorder with impairment in reading or dyslexia, I might be able to say, look, there’s just a lot of indications across their scores that indicate that they’re struggling. And then I just make that case to the disability officer or to … because sometimes the reports end up at like ETS or the GRE, Praxis, GMAT, LSAT, MCAT, helping them to understand this is how I’m putting it together.

Certainly, a diagnosis helps, it makes that a clean communication process between the professionals but even when that doesn’t happen, there are [00:18:00] ways you can … what I describe to the students I’m training is, I’m not asking you to abandon your ethical and professional responsibilities around adhering to diagnostic criteria before you lay out a diagnosis, but that doesn’t mean you can’t describe the individual in a way that’s consistent with the data you have and conveys to the people that will be consumers of the report, both the student and maybe a college, as to what’s going on and what might be helpful for them to be able to interact in that setting.

Dr. Sharp: I see what you mean. Have you noticed any difference between your audiences in terms of who prefers a diagnosis versus who’s more okay with just the description of functional limitation?

Dr. Martinelli: I do a lot of things for colleges and a number of those folks are looking for graduate programs so they’re looking at the GRE, LSAT, MCAT, [00:19:00] GMAT, DAT, for the dental school, those kinds of things. Those folks do prefer a diagnosis but they’re not oblivious to the idea of describe what’s going on for me and then help me to understand.

For instance, for both of those situations, there’s no real processing speed diagnosis but it affects what happens in these tests and in their schooling. So if you can describe, I can’t put anything down for diagnosis but I can describe, wow, they’re processing struggles in this arena, that arena, all arenas and that is helpful to them.

It’s really about, in my mind, explaining to these audiences why they’re doing worse than the average student. So for me, I’m looking at standard scores below 90 as a way of conveying that.

[00:20:00] Dr. Sharp: How did you come to that cutoff? That’s an interesting cutoff.

Dr. Martinelli: I think in two ways; one was, for most of the tests, that’s when they move out of average range into low average range as opposed to say the Bell Curve where you’re looking more like 85. It also comes from that disability conceptualization where you’re saying, look, they’re doing worse than 75% of the population.

There is no criteria that says it has to be less than 10% or 5%, so I just use that as a way of saying, this is where I’m going to start saying they’re probably doing worse than everybody else.

The other thing that prevents from a disability standpoint is the bright LD, the kid with 140 IQ [00:21:00] and 105 achievement scores, that’s 35 points. That’s a big difference, but if they’re performing at a standard score of 105, are they disabled the rest of the population? What I think used to be called bright LDs, does a kid who’s performing at like the 56th percentile rank, is that person functionally limited compared to their peers?

Dr. Sharp: Great question.

Dr. Martinelli: Probably not. Maybe they don’t need accommodation from a disability model, there may be other things that they might need and be helped with that you can make a case for someone can determine, but diagnostically, functional limitation-wise, maybe not so much.

Dr. Sharp: I see what you mean.

Dr. Martinelli: That tends to align with how most disability offices will [00:22:00] conceptualize when they need to do some sort of intervention or accommodation.

Dr. Sharp: That makes sense. I’m going to go back and stir up some controversy real quick. We’ve had, at this point, two folks on, where we have talked about processing speed and how the tests do or do not map onto real-world functioning. On the one hand, we had Ellen Braaten, who’s written the book, Bright Kids Who Can’t Keep Up, I’d say in favor of the idea that processing speed tests tell us some valuable information about how kids or adults are “processing” and performing in the real world.

And then Lovett came on two weeks later, just by coincidence, and said out of the blue, well, we don’t even know if these tests correspond to real life. So maybe you could be a tiebreaker for us here, for this moment in time.

Dr. Martinelli: I think [00:23:00] about it more from what’s going on in the school setting because so you sit in a college class and they’re going to give you a test and a lot of professors will say, class, you got an hour and a half to get through the test. And more often than not, that’s just an arbitrary guess as to how long it’s going to take to get through the test.

My experience has been; this is what’s going on. And so that’s what you’re going to do. Some students are like, oh my gosh, I can’t do that. My experience as a disability officer, and then it would just make me think as a psychologist, I get a student come in and they say, I just can’t, it’s an hour-long test and at 55 minutes, I still got 10-15% of the questions to get through.

And we get some [00:24:00] corroborating information. We say, okay, we’ll provide you for a time and a half. And they’d get an hour and a half on this hour-long test and they’d finish it in 55 minutes. At some level, that doesn’t make sense but often what it seemed to be anecdotally was, they were so anxious about the timeframe that once we removed the anxiety about it, then they functioned more typically.

That’s been a real battle of sorts on those high-stakes tests about what’s the appropriate way to look at that because the research tends to show that everybody getting extra time tends to help everybody do a little better to help those with disabilities a little more at some level, but even the reasonably bright folks that are taking these do better. And [00:25:00] that can have pretty significant implications around admissions and schools and all those things.

For me, I look at it from, if they’re processing slower, what we’re going to be doing in the college setting is giving them a little more time. I would also say, though, that sometimes we would see recommendations for unlimited time, for quadruple time. From the disability side, I’d push back on that.

I got documentation with someone recommended quadruple time, four times the regular time. And I said, I’m struggling with that because you’re going to go get the finals and you’re going to have a three-hour final and 12 hours in the testing center doesn’t sound like an accommodation. It sounds like something we have to give you parole for.

You’ve got to find some better way than, and we would look at things like double time on half the test one day and then double time on [00:26:00] the second half, another day and you only got to look at 1/2 of the test each time, but 12 hours in the testing center, I don’t know how anyone manages that, but maybe four or five, six hours on one day to go home, relax, get your brain cells back and then come back the next day and do it again, that might be more reasonable than saying they get 12 hours in the testing center.

Dr. Sharp: Isn’t there some research out there that says that for folks with ADHD, it might be detrimental to give extra time. I am remembering right?

Dr. Martinelli: Well, and then you get someone who’s got maybe a little more on the obsessive-compulsive spectrum, they’re going to go back and just go after every item. Giving them more time just gives them more time to often change an answer that was initially right because they overanalyzed it.

I think that’s an important piece of what we do around [00:27:00] and if you’ve been more hyperactive, giving them more time, they don’t tend to use it. More inattentive type, they go after the Bahamas in their mind and they need to come back and realize, oh my gosh, 10 minutes has gone by on a test that might be helpful to them.

My experience has been, the students who are more hyperactive, they’re just burning through the items anyway. They just want to get out of there. Extra time doesn’t do them much, which has been reflected in one of the accommodations that the GRE and the Praxis offer, which is extended breaks. That can be a really helpful experience for a student with those kinds of issues where they just need to, during a break, need a little more time to work out wiggles or whatever, just reset themselves before they go back in, more time didn’t help them, but more time on a break did.

Dr. Sharp: Yeah, I could see that actually. [00:28:00] I’ve run into a few different ways to get extra time. It’s not so much about extra time, it seems, especially for those with anxiety, it’s more having space and not feeling as constrained.

Dr. Martinelli: Right. And so being able to explain that to the university folks and the reason why you think that will be helpful to them in the sense of giving them access, allowing them to demonstrate what they know, can be helpful for the student and for the disability office to do that because I think it’s important to understand most, many, I don’t know what the right term is, nearly all disability folks have a graduate degree but there are very few that have a lot of psychometric understanding, testing background, very few are psychologists.

Here in [00:29:00] the state of Utah, it’s a little weirder, Brigham Young University’s Disability Director has a Ph.D. in psychology, the University of Utah’s Director has a PhD in psychology, so they understand that stuff. I can speak to them much easier than I can some of the other folks about what the testing means and how it works.

So being aware of that audience is helpful and being able to say, look, you’re going to have to, although they’re professional and although they understand disability stuff, they may not understand some of the technical language that we use in testing or how to say, well, that score means this impact. We have to do some of that work for them in a way that makes it a little easier for them.

Dr. Sharp: So does that shape how you write the reports?

Dr. Martinelli: The other thing I try to do, since I’m working with a lot of [00:30:00] 18 and older folks, is I feel like I want to make sure that that individual understands the testing. So I try to find a middle ground where I’m writing so the client understands the report and that a future clinician or evaluator may understand the report as well. That tends to work well, where you can say, look, let’s just explain how this is.

Like you’ve talked before with Karen Postal about Feedback that Sticks, this idea of helping people understand the feedback that we’re going to give them about the hours and hours of work that they’ve done in a way that helps them to explain it as well because one of the things we tend to find in the disability office is kids who come from the K-12 setting saying, I was in resource classes. I was accommodated. When I would ask them what for, they would say, I don’t know.

[00:31:00] So you were in six years of resource but you don’t know what for or why. I was like, oh my gosh, how did, and I understand sometimes why that happens. Sometimes parents or others don’t want to squash some sort of self-esteem or self-evaluative process and have them think that they’re deficient.

But if you can’t explain how you struggle and how you function, what works for you as well as what doesn’t, it can make the transition into college really tough because you become your own self-advocate in the college system as opposed to mom and dad and others advocating for you in the K-12 system. And so make sure that the individual can explain and understand what works for them and what doesn’t, is really important at the college setting.

I spend a pretty good time explaining to them what these results mean, how it will affect them, where in the school system, where it might be problematic for them and this is what might be helpful, [00:32:00] is sometimes eye-opening and enlightening for them. Sometimes people are like, now I finally understand what’s going on in my life. I feel great that I was able to do that for them but I feel really sad that they had to wait until they were, some of these folks are mid-20s, sometimes it’s folks who are returning to school because of the nature of my college, they’re coming back and saying, for 40 years, I couldn’t understand why I couldn’t do math.

Dr. Sharp: Oh my gosh.

Dr. Martinelli: They thought they were stupid. They were told because they’re 50 years old and back then it was like, you’re not trying hard enough. You’re not spending enough time and I’ve saying, well, no, I think there’s some other issues here around fluid reasoning and number sense and all that kind of stuff.

They’re like, oh, well, so I’m not stupid. No, you’re not stupid. You have a [00:33:00] disability in math and we’re going to do some things like a math substitution since you’re a communications major, and you’re not going to have to get through college algebra before you can finally graduate. We’re going to take you through a logic class or some other kind of course that will not by no means be easy, but you’ll likely be able to get through it and then you graduate and they cry in my office because they’re finally going to graduate.

Dr. Sharp: Oh, that’s amazing. It feels great.

Dr. Martinelli: Yeah. That’s why we get into this, I think sometimes so.

Dr. Sharp: Oh, absolutely. It’s funny. It reminds me, this is a little bit of a detour but we’ll come back, I promise. When I have kids and young adults here in the office, mostly teenagers, where they may have math issues, I share with them that I did not take a formal math class after high school yet I was able to get my PhD. When you said logic, that’s what [00:34:00] reminded me. I had this terrible nightmare calculus class, my senior year, first-year teacher, not great. And then I got to college and it was like, I don’t want to take math. And they said, oh, you can take logic. So I took logic and then didn’t have to do math until statistics, which was easy math.

Dr. Martinelli: Right. That’s the interesting thing is, sometimes students they’ll hate math but they’ll get into statistics, and all of a sudden it makes sense. I think there would be a reason for that.

Dr. Sharp: Right. Let me circle back. I’ve had all these lingering questions, but one I want to check in with you is I’ve heard anecdotally, maybe it’s research-based, it’s hard to remember all the different facts, that individuals in the university setting tend to be maybe at a higher IQ point than the average. They’re maybe 110 or 115. Is there any truth to that?

Dr. Martinelli: I think it depends on [00:35:00] the school. Having worked at BYU, which is a very competitive university to get into. The average ACT score at BYU is 32 and here at Utah Valley University, not so much because we’re open enrollment. So we catch folks who are looking at, we have some trade school programs and we have some master’s degrees and some competitive programs in the state and things from what.

At BYU, yeah, we saw a lot of kids. I think I can remember one or two times when we did a WAIS or a Woodcock-Johnson cognitive ability battery and see something in the low 90s. I think there was one time when we tested someone that was more in the 80s, then I was just like, wow, what must it be like to have a cognitability score in the low 90s and be sitting in classes with folks who are probably a good standard deviation above? [00:36:00] We’re trying to manage that.

I do think sometimes we see that in other schools. This is a horrible overgeneralization. I hope you won’t get a ton of emails from people hating me for saying this, but student athletes sometimes come in and they sometimes are really academically underprepared and haven’t had a real enriched K-12 system because of maybe their particular sport had them really moving that direction. Those folks, it’s been really interesting to try to figure out how we can be of help to a student who probably is bottom 5 percentile or 1st percentile of students at the university because of where their cognitive and achievement scores are.

Most college students are somewhere between 90 and 105, most graduate students are somewhere 100 to 110, and PhD students are [00:37:00] 10-something to wherever you want to stop the rainjet. That doesn’t necessarily mean whether or not you’re going to be successful. I’ve seen students with pretty low scores that have through great resilience, whatever, made it through and a lot of support, and other students who seem to have great scores but somehow it doesn’t work for them.

Dr. Sharp: Yeah. That raises another question since you work primarily with college students, a conversation that I have fairly often with certainly older high school students and some of the college students is around motivation. What do you do with these students who maybe they do have, let’s just say mild executive functioning issues or maybe like a slightly lower [00:38:00] academic ability in a certain subject, but it’s maybe motivation more than anything? How do you talk with them around those kinds of issues?

Dr. Martinelli: Sometimes that’s when I’m interacting with the other side of our university’s counseling center, where I’m saying, look, maybe some therapy would be helpful. They’re working with an advisor. Our school has a mentoring program that they work with. Sometimes hooking students up that way can be helpful.

There are some folks who offer things like ADHD coaching, academic coaching, and motivational interviewing kinds of things, hooking them up that way, which is outside the university system at some level and their services, but broadening them out to where things are.

There’s this real kind of take 16 hours and you’ll graduate in four years. If you take 16 hours [00:39:00] winter or fall, spring, you’ll get done in four years and go off and earn lots of money and pay taxes. One of the things I point out to folks is if you just take 14 hours instead of 16 hours, you’re going to take another semester. If you take 12 hours, it’ll take five years instead of four years.

And sure there are financial implications of that, but a lot of folks don’t graduate in four years or if they take 16, they’re always maybe failing a class and they have to retake it. So they take five years anyway, we’ll quit failing classes because of the impact it has on others and find that sweet spot of sorts in the way the schedule is structured for you that might allow you to manage it.

So, students who end up with specific learning disabilities, especially around reading, I spend a fair amount of time talking to them about; look at your [00:40:00] classes and talk to your advisors about how much reading is going to be involved here because even with an accommodation of books in an audio format, it may take you more time to study and to learn and to get through that book. You may be using technology and that technology may require more time with it and taking less hours or structuring that schedule in a way that gives you that time to do it will lead to more success than trying to keep up with some arbitrary number that says you’re going to graduate on a specific time.

Dr. Sharp: Yeah. Of course. I think for some students that can be relieving to know that they don’t have to plow through so quickly to get everything done. Let’s circle back, I haven’t really asked you much about the private practice side and the businessy aspects of that. I’m curious about that. How’d you go about starting that practice in the beginning? How did you get clients? How did you market? How’d you structure your [00:41:00] schedule? I’m interested in all of that

Dr. Martinelli: One of the things I noticed was we didn’t have a lot of testing available in some schools so they’d look for outside providers. The students would come back and say, wow, it’s going to cost me this much with the private provider. It’s going to take me this long to get it. That seemed to speak to me to two issues; one, if I could offer something a little lower cost. That probably meant if there was that much waiting time to get in to do this, there might be a place for another person and I wouldn’t be getting into an already flooded market.

So there was that piece and then having been a disability officer, I said, I think I know what most schools are looking for in their evaluation so I can offer just that stuff [00:42:00] and probably hit what colleges are looking for.

On the Facebook group, there are a number of folks who describe evaluations and some of them are pretty extensive and for good reasons. I’m not knocking their reasoning there, but for most of these college students who may be looking for a documentation update, they were in resource K-12, and they just need something with adult norms, giving them a good comprehensive Woodcock-Johnson battery, ruling out emotional concerns and ADHD concerns and writing that up really fit what they were looking for and what the college was looking for.

So I call it a pretty streamlined battery because typically it is Woodcock-Johnson COG, oral language if they’re having reading problems, and then the achievement battery with supplemental subtests if needed, [00:43:00] PAI or MMPI. I use the IVA for ADHD stuff and getting a feel for where those things are, write it up, and send it out.

So it was getting those tests together and already being comfortable with administering them, that was helpful. And then reaching out to the various disability officers at the various colleges and saying, hey, this is what I’m going to provide, this is what I’m going to charge, if students come in looking, if you’d feel comfortable sending them my way.

And then I did two things initially that I think were helpful. One is, about once or twice a year, I would call those disability officers, they knew who I was. It was pretty easy. And I said, how are my reports? [00:44:00] Are they meeting what you need? Is there anything you’d prefer me to do? Am I doing too much? Am I doing too little? Do you need me to do something else? Is the structure good? Are my conclusions good? Are my recommendations what you’re looking for? And then kind of tweaking things along that way.

Dr. Sharp: That’s really interesting. Let me interject for a second. You’re one of the only folks I’ve heard of that actually actively seek feedback on their reports like that. How has that process been helpful or not helpful? I’m curious.

Dr. Martinelli: Essentially, what I was doing was just LD evaluations and to a specific kind of population and so it wasn’t like maybe some folks who are talking to a broader audience and doing a lot of different reports, but it was helpful in the sense that they said, so one of the things I do in my reports [00:45:00] is I have pretty good tables that list the cluster scores and those kinds of things and then I would explain them.

The other thing I would do was I would attach the Compuscore on the back of the evaluation and the disability guys really liked that because it allowed them to, if new questions came in from the student about an accommodation, they could look back at the testing and say, is that supported, without having to have them come back to me.

A lot of the LSAT, MCAT, and GMAT folks want Compuscore as well to do their own analysis. So just including that with it was helpful and it’s not a huge expense. It wasn’t time-consuming. It didn’t increase overhead costs any, and they appreciated that. So making those kinds of things.

The other thing I did was once a year, I would figure out where people were referring me from and I would send them a, [00:46:00] there’s a group in Grand Junction who does a nice toffee and I would send them a little box of toffee. I did that for about the first three years and then it was like, oh my gosh, I can’t keep track of everybody they’re sending me and so I stopped doing that.

That was helpful as well, just to say, hey, thanks for putting me on a list. Just good customer service, good referral, take care of those that feed you kind of thing and it has worked really well.

In our prior conversation, I started in around 2009 and had about 13 evaluations and now I consistently do about 40 to 50 evaluations a year. Have done that for six, seven years. And that’s about, when you figure one a week in a part-time practice with all kinds of weird things, just by referrals, I think that’s not too bad.

[00:47:00] Dr. Sharp:  That works.

Dr. Martinelli: I also reached out at beginning to vocational rehabilitation. They paid a lot less than most folks but it got me someone in the door and kept it going kind of thing.

Dr. Sharp: That’s fantastic. I’m always curious how people build their practices. Logistically, do you take insurance at all?

Dr. Martinelli: I don’t take insurance because if I wasn’t wed to that process before, once I’ve gotten on the Facebook group and seen what that involves that I was just like, oh my gosh, that’s crazy. The involvement in the administrative hassle of that.

I just do private pay. I keep my costs pretty low. I’m not looking to make a ton that way, but I will say when I started in [00:48:00] 2009, I’m not going to give the actual numbers because I think that’s confusing based on where you’re at in the nation, they’re different. I’ve raised my fee somewhere around 75% from where it was nine years ago. Every year I did that, I was like, oh my gosh, I’m going to lose, all of a sudden the numbers are going to drop but maybe a little offset with the number of clients and it hasn’t made a big difference.

Dr. Sharp: How do you do that? Do you announce it to your referral sources or just do it internally?

Dr. Martinelli: Yeah, it has referral sources. I have a real basic website that I just say, here’s where it is and that helped. The other thing that helped with the practice, this is helpful for folks in the community is, got connected pretty early with the Learning Disability Association of Utah and a [00:49:00] child tutoring location called the Dyslexia Center of Utah and just talked to them a little bit about what I do and the expertise and if people had questions because these folks would get a lot of questions from adults and often they were started by people who are interested in kids and they didn’t know what to do or where to send them for adults.

And I just said, hey, if you’ve got people who have questions, I do testing, but if people want to know how this works and what colleges are looking for, feel free to send them my way and I’ll just talk to them and do that for free, that kind of thing. Just offered a little bit of consulting free stuff because it didn’t end up being a lot of time but that built a lot of goodwill about folks and then they would say, hey, I know a guy who does this testing and maybe I can check him out and see what goes there.

Dr. Sharp: Sure. It sounds like, just hearing you talk, that a lot of your “marketing” has been building relationships, maintaining those relationships, offering a little bit of [00:50:00] expertise on the side for free, just being a good person, an available person to answer questions and say thank you when people send you folks.

Dr. Martinelli: And that’s worked out pretty well because I never have made a brochure. I’ve never sent out any marketing stuff. I’m not sure that I could quit my day job and start doing this full-time just on that but I consistently have a waiting list of about 10 to 15 folks that are looking to get in and it varies from two weeks to get them into a few months. If I had more time, I see more clients, I just have to have a life and time to write reports.

Dr. Sharp: Good for you for preserving that time. Again, logistical questions because I know people might be interested. Do you have anyone [00:51:00] answering the phone for you or do you just handle that in the evenings or how’s that work?

Dr. Martinelli: I got myself, I’m going to tangent here, sorry. I didn’t have a cell phone for 100 years and then my wife wanted me to have a cell phone because she said, well, if you’re dead in a ditch someplace, I said, if I’m dead in a ditch, I ain’t using the phone. But we got me a cell phone and said, let’s make it the private practice number. We’ll give it out to a few people but that phone will be just the private practice phone and private practice will pay for it, which my wife, who’s got an MBA likes.

So she does my books, which are pretty straightforward because it’s all cash, credit, or check but the phone, if I’m not doing something, if I’m not with a student, I’ll pick it up and just get a name and a number and tell them they’re on the waiting list and get back to them when that [00:52:00] happens. Because I have done smaller kids, I’ll get calls from parents asking about their child and I’ll sometimes spend more time with them trying to either get them to link in with their school system or saying, this is what it’s going to take and this is where you might want to go and maybe I can do something for you and get you on the waiting list.

The other thing that’s somewhat helpful, and I think the institution is okay with this, I don’t do it a ton. I never test during the day and during my day job but I think there is something when they say, there’s this guy at my school and then this local school who knows stuff and is willing to walk me through it, that has some pretty good collateral help to the institution to say, oh, the guy at UVU is really nice about these students. That can be helpful. A lot of the time, that’s leave a message, I’ll get back with you after [00:53:00] 5:00 o’clock and go from there.

Dr. Sharp: And this just worked.

Dr. Martinelli: I do a lot of things on Saturday. I will also say, when I’m making phone calls at 7:00, 8:00 o’clock at night, I catch a lot of people that I wouldn’t catch during the day.

Dr. Sharp: That’s interesting. I think about that, whether that’s useful or not or if it seems strange or unprofessional, but it sounds like it’s working for you.

Dr. Martinelli: It works for me. On other podcasts, you’ve talked about administrative assistance and those kinds of things, for my small practice, it might be somewhat helpful but it hasn’t been a big deal for me, but it is sometimes nice when people call up and they say, hi, can I talk to Dr. Martinelli? And I say, you got him. Oh, really? I thought you’d be, and we have a nice then conversation and I’m able to build that relationship from the beginning. There are days where I’m like, oh, someone would just [00:54:00] call these people and find out when my next opening is. I see the value of that too.

Dr. Sharp: Sure. Well, it sounds like it’s working. You’ve carved out a nice little practice that fits well with your day job. That’s what it’s about. Do you have any conflict of interest there? Do you have to turn away folks from your own university?

Dr. Martinelli: Yes, I have. I have a form that they sign with my private practice that indicates two things. One, they are stipulating, they are not a student of UVU. We’re not going to be one real soon. I talk to them about, look, if you’re a year away from coming to UVU, you may just want to wait because we charge $250 at the institution for an LD evaluation and that’s a screaming deal. And so we have about a four or five month wait for our LD testing.

The [00:55:00] BYU comprehensive clinic charges about $100, maybe $75 for an evaluation but they’ve got like a yearlong waiting list as they use their clinical students to do it. But if you got time, that’s not a bad deal. I tell them, look, if you’ve got time, you may want to wait and get a much cheaper option.

If you are a current UVU student, no, I’m not going to take you and there may be other folks in the community that might be able to help you but I’m not going to, and the university makes me sign a conflict of interest form and I have to show them the forms that I have. I don’t want it to get messy because I don’t want to lose the options for either one.

Dr. Sharp: Oh, gosh, yeah, of course. We’ve covered a lot of ground and our time has gone by quick. This is great. Before I let you go, switching back to [00:56:00] the university side, I always like these applied questions around what are some of the most appropriate accommodations in the university setting for, let’s just say ADHD, dyslexia, and anxiety. Are there any that are just totally inappropriate that you see people ask for that just don’t fit?

Dr. Martinelli: The unlimited time is a big, time and a half, and double time are pretty much where things go. You have better have a really good reason if you want to go beyond that and maybe be a little more creative on what you’re trying to explain.

The other things we would have; we’d often get requests around time extensions for assignments. That one’s a little harder. [00:57:00] The reason that becomes hard is typically, you are still required to finish the course within the 14 to 16 weeks that a semester goes and if you start giving them much more time, by the end of the term, they’ve got a whole lot to get done to not have an incomplete and be really far behind. Often that work, I used to call it a nuclear accommodation because it would do amazing things for some and it would just absolutely devastate others. Those were a little wonky.

One thing I think is important for providers to know is what you write in the report, we would get some weird things that sometimes came out of the K-12 system. Let Johnny retake exams until he passes. That doesn’t tend to work at the college setting.

Dr. Sharp: Oh, geez. [00:58:00] Happy to say I’ve never recommended.

Dr. Martinelli: Or Johnny only has to do half the homework and sometimes that’s something that may occur under IDEA and the school system, don’t make this poor kid have to spend six hours of homework, but at the college setting, typically that doesn’t work real well.

The thing that I think was important, we’d say this to students and to providers, what you write in the report does not obligate the school and at the same time, if you’ve left something off, that doesn’t mean that they’re never going to do it.

Dr. Sharp: Interesting.

Dr. Martinelli: So making a good cake, the reports, if they’re good at describing and defending where the student is struggling and in what way those processes you’re pulling together, you do the student a really good service because it allows the disability office to do their analysis of what an appropriate accommodation [00:59:00] is.

Dr. Sharp: Okay. That’s interesting to me in that, gosh, I operate under the assumption that I just need to be very explicit, very thorough with recommendations but it sounds like you’re saying, hey, a lot of these disability offices, even if you don’t explicitly state an accommodation, they might be able to take the ball and run with it and extrapolate some of the findings.

Dr. Martinelli: Right. Certainly, a good evaluation with good recommendations like you’re describing, oh, I love those when they came in, it was so nice. It was just this breath of fresh air, both for the student, because they felt like they understood what was going on and what they were asking for and why it was reasonable and as a disability officer, it was great to say, yes, I see how this fits and I’m not going to have to work any harder than I have to. I get to work more on, this is how we’re going to implement it. This is how it’s going to happen. This is where it’s going to work and if you have problems, come back and visit with me [01:00:00] as opposed to, do you understand what this guy said? And they’re like, no, and neither do I.

But that also speaks to, there is no real definitive guideline for colleges as to what that process will look like, both in documentation, in report meeting, how soon it has to be done, what they’re looking for, and that’s where if you’re going to be doing a lot of these; reaching out to the local colleges and talking to their disability officer around what they need and what they want can help you to really write something that’s helpful. And that comes back to you over and over again when people say, that’s the person who writes us good reports, gets good things for us and helps us to do our job.

I would only say that talking to them the first few weeks of the semester is probably not going to be a successful opportunity [01:01:00] because they’re going to be busy getting their students squared away. Somewhere about the middle third, like the second third of the semester, that 5th and 10th week, things slow down a little bit. Summers can be a time when you can build those relationships.

It probably won’t be a super lengthy conversation where you can just come in and say, look, I’m looking to do this, how can I be of help to you? What are you looking for? Those kinds of things can be really helpful.

The other thing that’s helpful is, in my practice, I expect full payment by the time I’m giving them the report. I haven’t really had the problem with that occurring, getting it by that time. There are other folks who might, in reference to some of the things that you’ve put on the podcast, getting that credit card and billing on a regular basis, those kinds of options are really helpful to college students who have really limited large amounts of funds to pay for testing. [01:02:00] If you can work out a payment plan for them, you may be able to get more clients because you’re willing to work with them around a real limited income stream.

Dr. Sharp: That’s good to know. Cool. Well, let’s see, Ed, you shared so much with us. I’m super grateful. Is there anything else, any resources, anything that you have found helpful in your practice or navigating the university side of things, anything you’d like to share with folks?

Dr. Martinelli: Other things that you’ve talked about on the podcast templates are the thing that saved me each and every time. Being brief is helpful. Remedy is the soul of wit as a former friend of mine used to say about reports.

And then looking at what the documentation requirements are of the places you may be going. The [01:03:00] documentation requirements for folks like ETS for the practice in GRE may be very different than colleges. For years, the University of Utah wanted basically a full LD evaluation for their ADHD students because they wanted to see how it might fit. Other schools, Salt Lake Community College, BYU, were much more comfortable with some good self-report and objective measure, maybe something around executive functioning or processing speed, and they were good then looking at doing those kinds of accommodation requests.

That’s a very different cost and time commitment for the student and for the evaluator, knowing who you’re writing for, because if I’d have written one years ago for say, BYU, but sent it to the U, they probably would have had to come back in and get something more on the other side. If I’d done something like I did for the U and sent it to BYU, they might’ve said, wow, you paid for a lot of good work but you didn’t need all [01:04:00] that.

Dr. Sharp: Got you. Sounds good. Well, if people have any questions or want to reach out and get in touch with you, what’s the best way to do that?

Dr. Martinelli: Probably through my private practice website because some of these may be more related to that than the others. It’s ed@utahtested.com.

Dr. Sharp: Okay. That’s fantastic. I’ll have that information in the show notes as well as two other things that you mentioned that could be helpful.

I really appreciate it. It’s great to connect with you sort of in person after seeing in Facebook group and seeing a lot of things that you posted, I really appreciate you taking the time to be here and sharing all of this with us.

Dr. Martinelli: Oh, thanks for the invitation. I will say for folks who may not be as familiar with [01:05:00] some of the things you’ve talked about, the Facebook group, the podcast, the paperwork packets are really helpful to a lot of folks to not spend a lot of time, pulling it together and just go to work and do the things that you know, so it’s really helpful.

Dr. Sharp: Oh, that’s great to hear. Thanks. That’s great. I really appreciate it. Well, this has been cool. I know our paths will cross again soon online, most likely, take care in the meantime.

Dr. Martinelli: Thank you.

Dr. Sharp: All right, bye-bye. Okay, folks, we did it. Thanks again for listening. Hope you enjoyed this episode. I thought Ed was a great guy to talk to. Very easy conversation, also very knowledgeable.

If you’re not a member of the Facebook group, you are missing out. He is a great contributor in the group as well. Like I said, in our conversation, always posting relevant topics, research articles and just generally [01:06:00] being kind and sharing his expertise. So Ed’s in there. We are about 1300 other testing psychologists. So if you’re not a member of the Facebook group, check that out. It’s The Testing Psychologist community on Facebook. Lots of great discussion going on there.

Like I mentioned at the beginning of the podcast, if you are interested in paperwork for your testing practice; whether you’re just starting out, you want to tweak some things or you want to hire some folks, I’ve got it. Go to thetestingpsychologist.com/paperwork and check out those packets.

And last, if you need some help, you want some one-on-one support, some coaching on building your testing practice or growing it, I would love to help you out with that. That is the other branch of what I do here. You can go to thetestingpsychologist.com/consulting, get a little bit more information, and schedule a phone call just to chat and see if coaching would be appropriate for you. If it’s not, I’ll help you [01:07:00] find something that would be appropriate and we’ll get you where you want to go, but I would love to work with you.

All right, we did another one. I’ve got some great interviews coming up. I’m excited. Went through a little spell of solo episodes over the summer and now have several awesome interviews lined up. So stay tuned in, and subscribe to the podcast, you won’t miss any episodes. You can also rate and review if you’re feeling generous, it’s always super helpful with visibility and so forth and I will look forward to seeing y’all next time. Take care.

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