Day 32: Dr. Greenspan ( six figure education, $50 suite)

Dr. Stephen Greenspan- Psychologist
Was qualified as an expert in mental retardation. In this case he reviewed materials, voluminous records from this case. He got 4 binders containing 2,987 pages, a CD with 6,500 pages of transcripts, reports from other doctors, IQ tests given, school records, custody records, medical records, interviews of friends and family and school personnel, forensic testing, social security records, educational records for Tavia, prosecution interviews, commissary records from jail, and DMV records. Experts usually rely on this evidence. Dr. Greenspan wrote reports in 05/08 & 08/08 for this case. The criteria for diagnosing mental retardation is:
1. Intellectual functioning
2. Adaptive Behavior
3. Manifest before the age of 18

Dr. Greenspan reviewed this information prior to his diagnosis. Mental retardation is a developmental disability. There is a significant limitation in intellectual functioning and adaptive behavior. The term significant doesn't have to apply to adaptive behavior. Limitations coexist with strengths. The person doesn't have to be globally impaired in adaptive behavior. There only needs to be 1 impairment out of 12 subsections according to the AAMR manual. Intellectual criteria for mental retardation. This can be established through tests and records. A low score on an IQ test by a qualified psychologist can show mental retardation. There are only 2-3 reliable IQ test, and the "gold standards" are WAIS and Stanford Biene-5. Test have to be "normed" and standardized, given to a large portion of the population so you can get a generalization of how people fall after taking the tests. Mentally retarded people only represent 2% of the population. Dr. Greenspan reviewed and considered IQ tests given to Campbell. Dr. Greenspan didn't give Campbell an IQ. IQ test is the most important part of the full scale(FSIQ) or composite scores. Other scores are verbal(VIQ) & performance(PIQ) IQ. Campbell's scores:
Test Section Score Result
WAIS-R FSIQ 65 Mild mental retardation (MMR)
VIQ 64 MMR
PIQ 68 MMR

Stanford Biene-5 FSIQ 66 MMR
VIQ 72 MMR
PIQ 64 MMR

WAIS- III FSIQ 63 (64) MMR
VIQ 64 (66) MMR
PIQ 69 MMR

The maximum score for someone with MMR is 70. Above that would be in normal range. The normal person would score 100, and MR is 2 standard deviations away from the mean. The standard deviations are 15, so two standard deviations is 30 = 70. There is a standard error of 5. That means the technical range for MR is 55-75, so even if the score is higher then 70 the Dr. still believed it meant Campbell was MR. Dr. Greenspan said the consistency of this these three tests was considerable, he normally didn't see that consistency. Dr's have to use clinical judgement in their diagnoses. This is more limited in MR , and it is the special experience and expertise used to make decisions. Dr's can't just look at numbers and say a person is MR, they have to be thoughtful. Dr. Greenspan relied on reports from other experts and his own interview of Campbell for his decision. Dr. Greenspan's specialty is adaptive behavior and that is what he focused on. Dr. Greenspan said it isn't ethical to put a label on someone you haven't met with. There are 3 categories of adaptive behavior: Conceptional, practical, and social.
Conceptional:
Language- receptive ( understanding) and expressive (talk and responding to questions)
Reading and Writing
Money concepts (in the everyday world)
Self direction
Social:
Interpersonal skills (most important)
Responsibility
Self esteem ( not an indication of MR)
gullibility/naivety/ social vulnerability
ability to follow rules
Practical:
Activities of daily living
instrumental activities ( cooking for oneself, cleanliness)
Occupational

Adaptive behavior is learned skills people need to live their daily lives. How they are functioning in real world settings, are they challenging or unchallenged. The 3rd prong is onset is before the age of 18. Dr. Greenspan findings were that Campbell is MMR, and is the middle range of the mildly mentally retarded. Campbell was given a test called Street Survival Skills Questioner to test his current functioning. It is like an IQ test, and is understanding of activities of daily living. It has 180 items in 9 subsections. The Dr takes the correct answers and a table gives his age equivalency. Campbell's score was 68. Qualitative information is from friends, family, employers, reports and records. Quantitative information is standardized like test results. Dr. Greenspan normally doesn't rely on qualitative information, but there was so much in this case he used it. The standardized adaptive behavior test used were Vineland II and ABAS II. They are similar tests but use some different terminology.
Vineland II
Rater Role Age range Conceptional Practical Social Composite
R. Campbell Dad 10yr 6 mon 58 59 59 58
E. Barbary Friend 15yrs 52 43 54 50
J. Huffman Peer 15yrs 64 69
Underwood Peer 12 yr 6mon 73/65*
Harris Teacher 9yr 6 mon 57 - - -
Wonders Teacher 12 yr 6mon 62 - 59 -
Schulman Teacher 14 yrs 63 - 80 -

*this score was re-scored because it was too high. Dr. Greenspan also said the 80 score was still low and considered MR.
The answers to the test given were Campbell could- always do, sometimes do or never do. Questions asked about shoe tying, cooking meals and other daily life concepts. To be MR you have to be under 70.

ABAS
Campbell Dad 16-17 59 63 61 60

Teacher Rating Form
Harris 11yr 3 mon overall score: 63
Wonders 11 yr 3 mon overall score: 66
Schulman 14 yrs overall score: 65
Cobbley 17 yr 3 mon overall score: 74

There was a definite consistency between Robert Campbell Sr. It was very clear Campbell hit prong 2 of MR. Dr. Greenspan opinion is that Campbell is MMR. Mild is a misnomer, its anything but trivial. Dr. Greenspan read transcripts and listened to portions of the testimony. Dr. Greenspan said the mental equivalency was 10-11 perhaps 12 yrs old. The academic skill level is 5th-6th perhaps 7th grade in some areas. By Campbell blinking a lot it could be semantic and not cognitive. The Stanford-Biene 5 is a visual spacial test. It has to do with patterns, relationships, and spacial orientations. It was noted that Campbell has a particular weakness in this area of spacial relations. By listening to Campbell's testimony Dr. Greenspan heard: good vocab, good syntax, and good articulation (probably better then my typing). Campbell's volume was low and he had a flat affect. Dr. Greenspan said anyone can have a flat affect. It could show that Campbell was shutting down like a 10yr old would on the stand. The good vocab and syntax is very consistent of the MMR. 10 -11 yr old have good vocab, syntax and articulation.
LANE: Dr. Greenspan was selective in the information he read in this case. He believes he did a thorough job. Dr. Greenspan has to be a detective and find good "rates" that have good knowledge of Campbell in his daily life. The people tested didn't know Campbell that well. Who was Campbell's best friend as a child? Didn't know. Best friend as an adult? I believe Perez. Campbell said on the stand it was Quincy Gilbert. Dr. Greenspan wasn't certain if he read reports of what Gilbert told the police in this case. Dr. Greenspan did get police reports in this case. Who is Andrew Withers? Don't recall, Campbell isn't my client. Souza hired me, then who's your client? He didn't answer that. Who is Sebastian Cadena? Don't know. Priscilla Smith? Don't know. Sharon Baker? Don't know. Tyree Washington? Don't know. Christina Hogg? Girl on the jail tapes(got one right). Janee Gilmore? Don't know. The mother of Campbell's child? I don't know. Did they have a relationship? I assume. Adaptive behavior has to deal with if a person can live live successfully without supports. Mentally retarded need supports. Then you would need to find people who know Campbell well enough. Was your investigation handicapped by money? No. You also need to find someone who isn't biased? Yes. Couldn't a father who's son might be put to death biased? Possibly. Did you try the mother of Campbell's child? No, and Dr. Greenspan didn't know anything about their relationship. All the witnesses used were before the age of 15 except Ms. Cobbley? Correct. How has Campbell performed as a 30 year old? Very well, he doesn't have any write-ups in jail, not disciplinary action. Is MR a lifetime disorder? There are some that don't think so. Ms. Wonders took a test that had questions about Campbell's math ability, but said she only remembered reading and writing with Campbell. He didn't say why he didn't ask her about that even though he had her testimony. Ms. Harris wasn't a teacher, she was a library aide. Ms. Harris only taught Campbell about library skills and reading for about 20 mins a week. How could she answer math questions? I don't know. Eric Barbary was a Karate instructor. How did he rate the skills in writing? Never asked if he observed him doing any writing. Dr. Greenspan assumed he saw Campbell writing. Jason Huffman? Don't know his interaction with Campbell. Dr. Moseley? He tested Campbell and said Campbell wasn't MMR, but had oppositional disorders. Dr. Moseley didn't think Campbell tried on the MR test he was given, because he scored a 50. The MMR could have disorders and still have MR. They aren't exclusionary. There is anti-social personality disorder. Dr. Greenspan didn't think Campbell met any criteria of anti-soccial disorder.
Anti-social personality disorder criteria. (After the age of 18)
1- unable to respect social norms in lawful behavior that leads to repeat arrests?
Campbell made dumb mistakes. Between the age of 18-22 Campbell was arrested 3 times, spent 1 year in jail for burglery. 3 felonies in 3 years doesn't meet this anti-social criteria.
2- Decietful with acts of lying?
Dr. Greenspan says Campbell hasn't lied. His testimony did have exaggerations. There was also thefts, those are considered lies.
3. Failure to plan ahead?
Didn't answer
6. Couldn't consistantly meet financial obligations or hold a job?
Dr. Greenspan says not being able to hold a job is also MR. Campbell worked as a cashier at Mervyns and McDonalds. Dr. Greenspan assumed Campbell flipped burgers.
7. Lack of remorse?
Dr. Greenspan says Campbell has tremendous remorse. He didn't answer questions about remorse about the Good Guy's incident, or when he was pulled over riding a mini-bike.

Is psychology an art instead of a science? Could be both, but would agree with that statement. Dr. Pablo Stewart said Campbell had a sever speech defect and had a very hard time understanding Campbell. Dr. Greenspan didn't notice any speech defects. Dr. Greenspan said this might be an overstatement by Dr. Stewart. Dr. Greenspan couldn't find that Campbell's words made no sense.

That's it, back tomorrow 9am.