How Neuro-Bias Shows up in Professional Testing

Last month I took the exam to become a Board Certified Art Therapist. It was the first time I took a standardized test knowing that I am an autistic adult.

It was also the first time I could see how neuro-bias impacted my ability to perform well on the exam.

Let me explain. The art therapy board exam consists of 200 multiple choice questions given in 4 hours. No practice exams are available. Only a small group of sample questions are provided with an answer sheet (no explanations of the answers are included).

"Unnecessary Complexity" Illustration by Jackie Schuld

Given there are no practice exams available, I did my best to study by reading all of the material provided in two art therapy preparation books. I also reviewed the ethical guides provided by the art therapy credentials board and the American Art Therapy Association. I made flashcards of anything I didn’t know, and practiced with friends and by drawing out my answers on large murals. I was prepared.

What I couldn’t prepare for was the style of questions that heavily skewed toward neurotypical thinking. Many of the questions were posed in this style, “If an art therapist encountered (insert scenario here), which of the following would be the best next step?” I have to provide vague examples here so I’m not violating the ethics of the exam and sharing actual test questions.

Another broad example includes, “If an art therapist wanted to set up an art therapy studio in (insert location here), what should they do first?”

What I do first in most scenarios is far different than most people. I know everything I should do, but I will inevitably approach things in a different sequence than a neurotypical person. Furthermore, I often do multiple things at once to ensure I am extra safe, cautious, and therapeutic.

So if the question had asked, “Which five things are essential for the art therapist to do?” I could have easily named those five things. But which to do first? This autistic was lost.

There are two things that could help me answer that question as an autistic individual:

1. More information about the scenario

OR

2. A practice exam so I can teach myself to think like a neurotypical test taker. Essentially, let me learn the system and I’ll be able to pass the test.

There is nothing I could have done to prepare better for that exam with the material I had.

This is the first exam I’ve taken since learning I’m autistic. It makes me wonder if this is why I’ve always done better with essay tests than multiple choice tests in the past. I don’t recall the tests well enough to know if they skewed toward neurotypicals. Even if they did, I know many exams I’ve taken, such as LSAT for law school, provide AMPLE practice tests so I could learn how to be successful even if it’s not the way you traditionally think. I did very well on the LSAT because I learned how to think the way they wanted me to think.

The American Art Therapy Board Exam is an example of a non-inclusive neuro-biased test. I think this is an example where an accommodation for neurodivergent people (providing sample tests and explanation of the logical reasoning behind the answers), would benefit both neurotypical and neurodivergent people alike. I think that most things that would make the world easier for neurodivergent people would also make it easier for neurotypicals.

Post Script: In case you were worried, I passed the exam. I got 70% correct and luckily that was enough. I still think the exam preparation materials should be Neuro-inclusive.

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