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Competency To Stand Trial - How To Assess for the Functional Objective: Competence Assessment for Standing Trial for Defendants

Posted Jan 14 2009 7:25pm

As a follow-up to my post here, I now introduce the CAST-MR. I really like this assessment instrument, because it provides a firm starting point for defendants in that gray area, IQs between 55-75. Individuals with an IQ over 75 generally will not be cognitively impaired enough to be incompetent (unless there is a separate cognitive issue, such as memory problems, which will need to be assessed through other tests and procedures). Under 55, and an informal assessment will likely be enough to document current incompetency (of course, if one does better than expected, then the evaluator can simply introduce a more formal assessment device). In the gray area, I like to start with the CAST-MR.

The CAST-MR is a 50-item assessment designed for use with individuals experiencing cognitive difficulties, including mental retardation. The first 40 items are multiple choice in nature, and assess each prong of competency in general (i.e. no questions specific to the defendant’s own crime). The last 10 items are open-ended, and they assess the defendant’s knowledge of the crime for which they’ve been accused. The multiple choice items have three answers per item, while the open-ended items allow for scoring based on the degree of specificity in the answer.

What I really like about the CAST-MR is that it allows for a solid assessment of a defendant’s factual understanding of the issues related to competency, and it provides a very nice sets of normative data for comparison. Specifically, the test provides norms for individuals without mental retardation, individuals with mental retardation (avg. IQ of 59) who were found to be competent via other measures and means, and individuals with mental retardation (avg. IQ of 58) who had been found to be incompetent. This allows an evaluator to compare a defendant to all three groups, on all three parts of the test, as well as the total score based on all three items.

I find this to be a nice way to obtain a basic idea of a defendant’s factual understanding of issues related to competency. If an individual’s scores match fairly well with the normative group that is both competent and not mentally retarded, not only do I know they have a firm factual understanding of these issues, I generally expect the defendant to do well on the R-CAI. If they score commensurate with the middle group (mentally retarded but competent), I understand I will likely need to use the R-CAI in a manner that thoroughly assesses the individual’s rational understanding, with a significant amount of follow-up questions, alternative ways of asking questions in order to obtain the individual’s true knowledge, etc. If they score commensurate with the incompetent and mentally retarded group, an R-CAI is likely not necessary, unless their poor performance can somehow be attributed to something else, as noted here.

To sum up, I use the CAST-MR with individuals with low cognitive functioning in order to obtain an initial assessment of their understanding of the issues related to competency. Based on that score, I can then proceed to the next part of the evaluation. In addition, the normative data not only allows for a solid understanding of how to proceed, it provides excellent numbers to include in the report to the court, which allows for the judge and attorneys to have a better idea of where the defendant’s understanding actually lies. The individuals involved in the legal process will typically appreciate data like this, because it gives them both a solid number, as well as something to compare it to. If a guy’s IQ is 110, no one disputes he is intelligent enough to be competent. If the IQ is 67, it is nice to be able to provide as much specific information as possible, so that the evaluator’s recommendations are easily understood in the context of the data, and do not appear to be based solely on the evaluator’s personal opinion. When I can say that a guy with an IQ of 67 scored better than the average of those who were found competent, and were not mentally retarded, the issue of IQ and cognitive functioning becomes less of an issue.

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