Harmonizing Clinical Assessments in a Minority Group

Anu Haavisto, University of Helsinki, Helsinki, Finland
Susanna Slama, University of Helsinki, Helsinki, Finland
Johanna Rosenqvist, University of Helsinki, Helsinki, Finland


Cross-cultural differences exist in test performance, yet many minority groups lack their own normative data. One such minority group is the Swedish-speaking Finns, or Finland-Swedes, that constitute 5.2% of the population in Finland. There is no consensus about the test methods that should be used when assessing Finland-Swedes. Practices vary and some clinical psychologists use a translation of the Finnish tests with their Finnish norms, some use the existing Swedish test versions with norms from Scandinavia (Sweden, Norway, and Denmark), while others combine Finnish and Swedish tests in the same assessment. There is a lack of validity evidence to support which procedure is the most reliable. The only evidence comes from a previous research study, which demonstrated that Swedish-speaking children performed significantly lower on the translated version of the Verbal Index compared to the Finnish normative data, indicating that reliability may be compromised when translating verbal subtests. The aim of this research initiative was to harmonize clinical assessments of Swedish-speaking children in Finland.

Participants and Methods:

Due to the lack of evidence of possible group differences between the Finland-Swedes’ performance on the Swedish test versions, The FinSwed Study research initiative was founded. The research initiative assessed 276 Finland-Swedish children aged 5–16 years with the Swedish WPPSI-IV and WISC-V. Based on the research results, guidelines for harmonization of test assessments were drafted by the research group. Experts in clinical psychology and neuropsychology convened to review and comment on the proposal, and revisions were made accordingly. The guidelines were then reviewed and endorsed by the Test Committee of the Finnish Psychological Association.


The research initiative will result in national guidelines to unify cognitive assessments for the Finland-Swedish minority group. Swedish test versions with minor cultural adaptations are recommended as the newest test versions (WPPSI-IV/WISC-V) are not yet published in Finnish and unofficial translations can then be avoided. The practice guidelines will also describe the test profile observed in the Finland-Swedish sample and give recommendations for interpretation. Generally, the Finland-Swedish sample performed higher compared to the Scandinavian test norms, in the WPPSI-IV the FISQ was 104 and in WISC-V 103, with some variation by age. Based on these results, it is important to consider that the Swedish test versions, with their Scandinavian norms, might result in inflated scores for Finland-Swedes, particularly in certain age groups. In both tests there were variations in the test profiles. The mean performance in the verbal subtests was the most uneven. Thus, verbal items seem to have a lower reliability when used in another language context. Within the Visuospatial, Fluid, and Working Memory Indexes the subtest scaled scores were more evenly distributed around scaled score 11. In the guidelines, these results will be presented in graphs to make them easily available for clinicians.


The purpose of the guidelines is to ensure uniform and fair cognitive evaluations. Consequently, the aim is to contribute to maintaining a high standard of professional psychological practice.

Category: Cross Cultural Neuropsychology/ Clinical Cultural Neuroscience

Keyword 1: cross-cultural issues
Keyword 2: assessment
Keyword 3: test reliability