Opinion ID: 3176573
Heading Depth: 3
Heading Rank: 1

Heading: Brumfield’s Three Expert Witnesses

Text: The asserted role of Brumfield’s first expert, Stephen Greenspan, Ph.D., 5 was to educate the court on intellectual disability. While Greenspan did not evaluate whether Brumfield was intellectually disabled, the district court held that Greenspan “is one of the foremost [intellectual disability] experts in the country.” Brumfield II, 854 F. Supp. 2d at 386. Greenspan testified generally as to the “proper use of the AAIDD’s clinical standards in making diagnoses of [intellectual disability].” Id. Beginning with the subaverage intelligence prong of the intellectual disability test, Greenspan explained that psychologists originally used an IQ score of 70 as the cutoff for determining whether an individual had an intellectual disability, but because of advances in scientific and statistical methods, the AAIDD uses “75 as the upper ceiling now” for a diagnosis of intellectual disability. Commenting on potential factors that may affect the validity of an individual’s IQ score, Greenspan explained that if an individual is “malingering,” which refers to intentionally performing poorly on a test, an IQ test score may not be valid. He further explained that consistently receiving the same IQ score across multiple tests generally rules out malingering by an individual. When Greenspan examined the IQ scores from Brumfield’s previous tests, the scores “[told him] that [the test subject] here . . . clearly me[t] prong one because all of these scores [we]re in the mild [intellectual disability] range.” Greenspan also noted that an individual’s IQ tends to remain stable over time, implying that Brumfield, absent some incident that lowered his IQ, has always had an IQ in the intellectually disabled range. 5Greenspan is a licensed psychologist, obtained his Ph.D. in 1976, and (at the time of the hearing), was employed as a visiting professor at the University of Colorado Medical School. The district court accepted him as an expert in intellectual disability and adaptive behavior. Brumfield II, 854 F. Supp. 2d at 386. 7 Case: 12-30256 Document: 00513375522 Page: 8 Date Filed: 02/10/2016 No. 12-30256 When discussing the second prong of the intellectual disability test— whether an individual has impairments in adaptive behavior 6—Greenspan explained that “adaptive functioning usually would determine whether somebody is really [intellectually disabled]” when a person’s IQ is close to the cutoff for an intellectual disability diagnosis. “Adaptive behavior has to do with how one functions in the real world . . . outside of the testing situation.” Adaptive behavior includes three domains: the practical domain, the social domain, and the conceptual domain. The practical domain concerns daily living skills, the social domain concerns whether an individual can conform to the rules of society, and the conceptual domain concerns quasi-academic skills applicable to the real world, such as telling time. A diagnosis of intellectual disability requires “at least one . . . major domain of a relative impairment.” However, Greenspan was careful to note that an impairment in one domain of adaptive behavior does not require the complete absence of adaptive behaviors in that domain and that it does not preclude the possibility that an individual possesses some strengths in particular areas. To measure adaptive behavior in an individual, psychologists administer tests, such as the Adaptive Behavior Assessment System (ABAS) questionnaires, to people who know or knew the individual being evaluated for an intellectual disability. Greenspan emphasized that “the more people you can talk to, the better picture you get of an individual.” He also noted the importance of interviewing the subject himself. Greenspan testified that when sufficient records are available, reviewing all of the available information can shed light on whether an individual has deficits in adaptive functioning. He further noted that reviewing records is important when evaluating whether an “Adaptive behavior,” “adaptive functioning,” and “adaptive skills” are used 6 interchangeably in both professional psychology circles and during the district court’s Atkins hearing. 8 Case: 12-30256 Document: 00513375522 Page: 9 Date Filed: 02/10/2016 No. 12-30256 individual satisfies the third prong of an intellectual disability diagnosis— manifestations prior to the age of 18. Additionally, Greenspan explained that the presence or absence of “maladaptive behavior” is not relevant to the diagnosis of intellectual disability. Maladaptive behavior involves a “person act[ing] out” by, for example, “attack[ing] other people” and is “not used diagnostically.” Brumfield’s second expert, Ricardo Weinstein, Ph.D., 7 evaluated Brumfield for intellectual disability. During the course of his evaluation, Weinstein met with Brumfield on at least three separate occasions for between five and seven hours each time, administered psychological tests, and performed a clinical interview with Brumfield. Weinstein also reviewed school records, medical records, and other records relevant to Brumfield’s past. Finally, Weinstein interviewed at least 14 different individuals who knew Brumfield. Based on his evaluation, Weinstein diagnosed Brumfield as intellectually disabled. Focusing on the first criterion for intellectual disability, Weinstein administered two IQ tests to Brumfield in 2007. Id. at 389. Brumfield scored a 72 (95% confidence interval of 69–77) on the Stanford-Binet V and a 70 (95% confidence interval of 65–75) on the C-TONI. Both of these scores fall within the intellectually disabled range and thus meet the first prong of the intellectual disability test. Weinstein also noted that Brumfield’s scores on previous IQ tests were consistent with an intellectual disability diagnosis. 8 7 Weinstein received his Ph.D. in 1971, and at the time of the hearing, he practiced forensic psychology. The district court accepted him as an expert in intellectual disability and forensic neuropsychology. Id. Although the State questioned his credentials, correctly pointing out that he received his Ph.D. from a non-traditional school that is no longer in operation, we note that he is licensed by the State of California and completed a post-doctoral certificate at the Fielding Institute. 8 Based on other psychological testing, Weinstein ruled out malingering as a possible explanation for Brumfield’s IQ scores. 9 Case: 12-30256 Document: 00513375522 Page: 10 Date Filed: 02/10/2016 No. 12-30256 Specifically, a 1995 administration of the WAIS-R by then-defense expert Dr. Bolter resulted in a score of 75 (95% confidence interval of 70–80), and a 2009 administration of the WAIS-IV by State’s expert Dr. Hoppe yielded a score of 70 (95% confidence interval of 67–75). Because all four of Brumfield’s full-scale IQ scores fell within the intellectually disabled range, Weinstein concluded that Brumfield had satisfied the first requirement for an intellectual disability diagnosis. With respect to his evaluation of Brumfield’s adaptive functioning, Weinstein explained that his job as a psychologist “is to identify deficits,” and not to identify strengths in adaptive behavior, as “the issue . . . of . . . strengths is not relevant.” His evaluation of Brumfield’s adaptive functioning included his interviews with Brumfield and his review of relevant records. Additionally, Weinstein administered ABAS questionnaires to six people who knew Brumfield during his developmental years. However, because Weinstein admitted that the results of the ABAS questionnaires were “not very reliable,” 9 the district court “f[ound] these tests to be of little or no value,” and did not rely on them in reaching its conclusion on Brumfield’s intellectual disability. Id. at 393. The court did, however, consider Weinstein’s interviews with the people to whom he administered the ABAS questionnaires and at least eight other individuals, as well as his review of the records. Based on these interviews and his review of school, hospital, and group home records, Weinstein “identif[ied] very significant deficits in all three domains” of adaptive behavior. First, Weinstein noted that Brumfield was 9 As Weinstein explained, the ABAS was designed to be used contemporaneously while he was “trying to see how Mr. Brumfield functioned prior to the age of 18,” which required him to “ask[] people to remember how [Brumfield] functioned” in the past. Because “these backward-looking questions rely principally upon the memories of the test-takers regarding Brumfield’s abilities dating back 15–20 years,” id. at 393, the scores derived from the ABAS are not, in Weinstein’s opinion, very reliable. 10 Case: 12-30256 Document: 00513375522 Page: 11 Date Filed: 02/10/2016 No. 12-30256 developmentally delayed. For example, Brumfield was “two years behind his chronological age in terms of achievement or even grade levels.” Weinstein also noted impairment in Brumfield’s “visual motor coordination.” In particular, “Brumfield’s writing abilities are severely limited.” According to Weinstein, to write a letter Brumfield “needs to have a guide” and “uses a piece of cardboard that he puts underneath the line” in order to write in a straight line. Brumfield “takes . . . a very long time to write a letter”; in fact, a one page letter “take[s him] several days to write.” When writing, Weinstein noted, Brumfield “gets assistance from people in death row.” With respect to Brumfield’s behavior in the community, Weinstein testified that after “look[ing] at the records [and] talk[ing] to people,” he concluded that Brumfield “had problems with attention” and “with language comprehension.” Weinstein also concluded that Brumfield never learned any skills that could lead to gainful employment. Although Brumfield quit his job in order to sell drugs so that he could make more money, Weinstein stated that this did not suggest that Brumfield was able to obtain or maintain gainful employment. Commenting on the third prong of the intellectual disability inquiry, Weinstein noted that many of the adaptive behavior deficits, such as Brumfield’s academic progress lagging two years behind his age, were present during Brumfield’s developmental years. Although not part of the intellectual disability diagnosis, Weinstein pointed to several risk factors present in Brumfield’s history that support the conclusion that Brumfield manifested symptoms of an intellectual disability before he turned 18. For example, Brumfield’s mother “had psychiatric problems and was being medicated” and did not have “access to prenatal care . . . until she was about six months pregnant.” 11 Case: 12-30256 Document: 00513375522 Page: 12 Date Filed: 02/10/2016 No. 12-30256 Brumfield’s third expert, Victoria Swanson, Ph.D., also evaluated him for intellectual disability. 10 Swanson initially reviewed Brumfield’s records, particularly his school records, and the reports of other experts. Based on this review, she confirmed the earlier diagnosis of intellectual disability. Although she did not meet with Brumfield prior to confirming his intellectual disability diagnosis, she later met with him for five hours, interviewed people familiar with Brumfield during his developmental years, and broadened her review of the records. Swanson stated that nothing she reviewed or learned after writing her report changed her opinion or diagnosis. After reviewing all of the full-scale IQ scores Brumfield had received, Swanson opined that all of his scores fell within the range of intellectual disability and therefore concluded that Brumfield had satisfied the first prong of the intellectual disability test. Turning to the second prong—adaptive behavior—Swanson discussed Brumfield’s educational history extensively. In 1983, two teachers referred Brumfield for an evaluation within the school system. As part of this evaluation, Brumfield took a number of psychological tests, which indicated that Brumfield was functioning academically between 20 and 41 months behind his chronological age. 11 Based on the results of this evaluation, Brumfield was given the “exceptionality of behavior disorder” and 10 Swanson is a licensed psychologist in the State of Louisiana, and received her Ph.D. from Louisiana State University (LSU) in 1999. She has over 20 years of experience working with intellectually disabled patients. She also assisted the Louisiana legislature in drafting the bill that eventually became the statute governing intellectual disability at issue in this case. The district court accepted Swanson as an expert in intellectual disability and psychology. 11 The Illinois Test for Polylinguistic Abilities indicated that he was functioning at an age level 41 months behind his chronological age, the Peabody Picture Vocabulary Test indicated Brumfield was 20 months below his chronological age level, and the Woodcock Language Proficiency Battery indicated Brumfield lagged approximately 24 months behind his chronological age. As measured by the Woodcock-Johnson Psychoeducational Battery in 1983, Brumfield’s reading level fell into the seventh percentile. 12 Case: 12-30256 Document: 00513375522 Page: 13 Date Filed: 02/10/2016 No. 12-30256 placed into a classroom setting appropriate for students with this disorder. 12 After spending three years in the special education classroom, Brumfield again took a number of psychological tests. Explaining these tests, Swanson noted that “there hasn’t been any progress academically over the three years that [Brumfield] continued to be in [the behavior disorder] class, and he seems to have plateaued at about the same grade level.” She further opined that Brumfield did not make any progress in the behavior disorder classroom because he, in fact, suffered from an intellectual disability. Explaining that students with behavior disorder typically catch up to their peers once their behavioral needs are met, Swanson stated that Brumfield simply plateaued between a fourth and sixth grade level, which was “consistent with a person with [an intellectual disability] more so than with a person who is just behaviorally disordered.” Swanson also discussed Brumfield’s reading and writing skills at length. She noted that, while in prison, Brumfield possessed both elementary-schoollevel and collegiate dictionaries, but he was only able to effectively use the elementary-school-level dictionary. Discussing his reading ability more generally based on her interview with Brumfield, she said “he was able to read 60 words a minute, which is extremely low for someone his age, but would be consistent for someone with a fourth grade reading level trying to read at the tenth.” Based on her evaluation of Brumfield, Swanson opined that “a diagnosis of [intellectual disability] would be appropriate for [Brumfield]. He 12 Swanson explained that individuals can have both a behavior disorder and an intellectual disability. Moreover, “[t]here is a high instance of aggression amongst students with [intellectual disability]” because they “are being asked to do things that they can’t do,” which leads to frustration and aggression. When a student has both a behavior disorder and an intellectual disability, she explained, schools often place the student into the behavior disorder classroom. 13 Case: 12-30256 Document: 00513375522 Page: 14 Date Filed: 02/10/2016 No. 12-30256 meets criteria one; he meets criteria two, and . . . there’s evidence of deficits in at least two areas prior to the age of 18.”