Comments on “One Minute Intelligence Quotient Test for Point-of-care Grading of the Severity of Lower Intelligence in the Patient Populations”

Dear Editor, This write-up is a critical evaluation of the article “One Minute IQ Test for Point-of-care Grading of the Severity of Lower Intelligence in the Patient Populations” (Vol 3, Issue 2, July–December 2024) published in this journal in the last issue Vol 3, Issue 2 (July–December 2024).[1] The authors mention that it is a “test.” However, at best, it can be described as a procedure or at most it can be called as a screening question. Psychological tests are always standardized, with adequate validity, reliability, and normative data. The authors mention that their procedure can be used when there is no time. Tests such as the Vineland Social Maturity Scale,[2] Developmental Screening Test,[3] and Sequin Form Board Test[4] are standardized take about 10–20 min, and though they do not provide a true and wholistic picture of an individual’s intelligence quotient (IQ), they can be administered when there is time constraint instead of One Minute IQ Test (OMI-T). IQ score/diagnosis has long-lasting and serious implications beyond clinical management, such as disability benefits, academic and career endeavors, diagnosis of specific learning disability (SLD), job prospects, property rights, as well as legal and forensic aspects. The authors appear to not have fully considered these aspects. In the first paragraph in introduction, the authors incorrectly mention that based on the mental status examination (MSE), a person is put into only two (binary) categories, i.e., “average” and/or “below average/lower intelligence.” Further, in the next phrase, authors mention that “..without a severity grading for below-average/lower intelligence, it becomes challenging to formulate a comprehensive clinical management plan……” and …. “psychological tests take too much time..”. It is common practice that mental health professionals begin treatment in most settings before receiving the formal IQ report. Given this, as there are several quick standardized psychological tests that provide detailed information about intellectual function exists, the adoption of unstandardized methods by professionals as part of clinical assessment is unethical and unwarranted. Intellectual disability is a developmental disorder, where the main intervention is psychosocial rather than pharmacological. Further, the intervention takes months or years, depending on the severity level. Given this, it is always advised to have an “individual intervention plan” (by clinical/rehabilitation psychologists and psychiatric social workers), which is based on the actual comprehensive assessment of their abilities in multiple domains. Given the complexities involved in developing intervention for intellectual disability and ethical implications of labeling, it would not be wise to attempt to determine the IQ in one minute. Further, they mention “Cognitive Reflection Test (CRT)” as the world’s shortest test to support their claim. CRT claims to test intelligence by asking just three questions to the candidates. However, the authors ignore that the CRT is administered to the candidates (and not their mothers) and that it does not fulfill the basic requirement of psychometric properties and the “Standards for Educational and Psychological Testing,” developed by American Psychological Association. Later, the authors incorrectly claim that the procedure is a novel test. In fact, it has been a common practice for decades in the mental health field to ask caretakers to estimate a child’s mental age as compared to their age peers when evaluating individuals with below-average intellectual functioning. Furthermore, two prior research studies from India[5,6] have already employed similar procedures to estimate IQ. In the methods section, the authors bring in the history of intelligence testing of Binet and Terman. However, Binet’s and Terman’s tests were standardized, had a large number of items, and the purpose was completely different.[7] Further, in the description of their test procedure, they mention that the author formally asks caregivers, who are “average intelligent persons” that “Compared to siblings……. at which his/her intelligence has developed?” Here, it is not mentioned that how will the authors know that which caregivers have “average intelligence?” and how will the caregivers know what is intelligence? In the subsequent paragraph, they try to mention what needs to be done when there is a “confusion….” and try to suggest ways to overcome it. However, the process of assessing intelligence is not as simple as asking such questions to mothers, because in many situations, a mother may not know what conclusion to arrive at. Some examples of such situations are child’s speech is delayed but self-care is adequate to the age; the child can make purchase, but is shy in social interactions, and/or when the child has SLD or autism. Another significant limitation is that their study involved only 6 patients. The authors have not provided several important information, such as the sociodemographic (apart from age) and clinical details, sampling technique, and selection criteria. Table 1 in the article shows the values obtained by their procedure and the formal assessment. It can be observed from the table that the difference between the above two procedures ranges from “minus 5 to plus 26,” which is huge. Usually, in intelligence assessment, the margin of error is ±3 IQ points. Further, in terms of the intelligence categories, their 1-min procedure has categorized 3 out of 6 patients into different intelligence categories (such as moderate intellectual disability difference [IDD] into mild IDD, mild IDD into moderate IDD, and mild IDD into Borderline intelligence). The authors have not discussed these difference, but mention that “the visual analysis of the scores does not reveal any clinically significant differences.”Table 1: Showing the extent of the difference in the IQs between 1-min IQ and Formal IQFurther, the article is written as a brief research communication. The whole article appears as a “viewpoint” with data of six patients. However, they have not mentioned whether ethical clearance was obtained for the study. The author’s discussion appears to be based on flawed assumptions, questionable methodology, and results that may not have been appropriately obtained, as outlined above. Further, to justify their procedure, they bring in unrelated information/concepts that are not related to their study. In conclusion, due to the various reasons mentioned above, this article lacks practical psychometric or psychiatric use and has not followed proper scientific article writing procedures. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.