The OPQ guidelines on dyslexia

Guidelines for the assessment of dyslexia published by the Order of psychologists of Quebec

In January 2014, the Order of Psychologists of Quebec (OPQ) issued guidelines for the assessment of dyslexia. As written and presented, this document suggests that all committee members, including myself, endorse it. However, I do not endorse this document for the following reasons:

  • The methodology that was used to develop these guidelines is in my opinion suboptimal and not congruent with recommended practices in guideline development. It is perplexing that a regulatory body such as the OPQ would produce guidelines using a methodology that is generally considered to be of poor quality, despite the availability of numerous acceptable methods for guideline development, and especially in light of the power, both legal and moral, the Order has over its members. It is also perplexing that the Order could claim to be defining best practices in this document, while not using best practices in developing the guidelines. Perhaps more perplexing is that the Order requires its members to keep abreast of changes in practices in psychology, to keep up with the evolution of science in psychology and/or related disciplines, to maintain and update their skills, and to have a critical reflection on their practice, while the Order seems to adhere to much less stringent requirements. In view of the evolution of knowledge and practices in knowledge transfer and the development of clinical guidelines, it is difficult to understand why these guidelines on the assessment of dyslexia have not been developed using a recognized method.
  • Critical and important comments about the document have not been made available, thus keeping psychologists and the public from having access to information that could be useful to determine to what extent they should trust and adhere to the guidelines, and to understand the strengths and weaknesses of the document. One of the essential characteristics of any guideline is transparency. Unfortunately, here, psychologists are confronted to an organization that can be both judge and jury in that it defines best practices, in ways I believe to be doubtful in this case, and may require psychologists to adhere to these so-called best practices through such mechanisms as the accreditation of university programs, professional inspection of practitionners, or diverse actions taken by the Order’s Syndic.

  • At least 4 of the 5 members of the Advisory Committee, and at least 4 of the 6 members of the validation committee had not seen the final version of the guideline, despite the fact that it is quite different from previous versions, prior to its approval by the OPQ Board of Directors and its dissemination. Of these participants, nearly half have expressed some dissatisfaction with the document; their dissatisfaction and their concerns are not documented in the text or anywhere else. Two of the experts who contributed to the document also asked that their names be removed from the document. Their request was denied by the Order.

    In addition to problems in the methods used to design the guidelines, the development of these guidelines has other shortcomings that should be highlighted, including what appears to have been a poor and deficient management of the project, which has among other things led to a significant budget overrun, this shortly before a dues increase was requested to members.

    My concerns about the situation have been reported more than once and over several months to the president of the Order and to the Board of Directors. I have also proposed a number of ideas to prevent this from happening again.

    My position is based on methodological and ethical considerations, not on the potential usefulness (or uselessness) that these guidelines may have for members.

    Martin Drapeau
    Associate Professor, McGill University