Carmen Inoa Vazquez, Ph.D., ABPP Clinical Professor NYU School of Medicine Lead Litigation Conference Philadelphia May 19, 2009 Presentation

Transcription

1 Carmen Inoa Vazquez, Ph.D., ABPP Clinical Professor NYU School of Medicine Lead Litigation Conference Philadelphia May 19, 2009 Presentation Neuropsychological Tests Battery The following List represents an example (not fully inclusive) of test instruments used in the examination of children exposed to lead: Halstead-Reitan Neuropsychological Test Battery Luria-Nebraska Neuropsychological Test Battery NEPSY- A Developmental Neuropsychological Assessment Cambridge Automated Neuropsychological Test Battery (CANTAB) Neuropsychological Assessment Battery (NAB) List of Tests Measuring Different Skills and Domains: WJ-III - Woodcock Johnson Tests of Cognitive Abilities Third Edition WJ-III - Woodcock Johnson Tests of Achievement Third Edition (WISC-IV) Wechsler Intelligence Scale for Children (WIAT-II) Wechsler Individual Achievement Test Second Edition Trail Making Test CVLT-C - California Verbal Learning Test (WRAML2) Wide Range Assessment of Memory and Learning (GORT-IV) Gray Oral Reading Test Nelson-Denny Reading Test Cognitive Assessment System (CAS) Sentence Completion Test Behavior Rating Inventory of Executive Function Grooved Pegboard Purdue Peg Board (CELF-3)Clinical Evaluation of Language Fundamentals Expressive One Word Picture Vocabulary Test Receptive One Word Picture Vocabulary Test Conners 3rd Edition ABAS II Adaptive Behavior Assessment System Child Behavior Checklist 1

2 List of Attention and Executive Functioning Measures: Continuous Performance Test Stroop Interference Test Wisconsin Card Sorting Test Delis-Kaplan Executive Functioning Test Battery Behavioral Assessment of Dysexecutive Syndrome Selected List of Intelligence Tests: General intelligence/mental abilities/omnibus cognitive skills tests: These measures consist of subtests with various labels purported to measure aspects of cognitive function. Subtest scores are summed in order to obtain overarching measures such as IQ, often accompanied by omnibus measures of verbal abilities such as Verbal IQ/Verbal Comprehension Index, visual-motor or visuospatial skills for example Performance IQ, Perceptual Organization Index, Attention/working Memory, Attention Index or Speed of Processing. Bayley Scales of Infant Development Second Edition 1 year to 42 months McCarthy Scales preschool 9:6 to 8:6 months NEPSY II 3 to 16 years uses a developmental model The Das-Naglieri Cog. Assessment System (CAS) 2:6 to 17:11 months Woodcock-Johnson-III-Tests of Cognitive Abilities 2 to 90+ years Kaufman Adolescent and Adult Intelligence Test 11 to over 85 years Kaufman Assessment Battery for Children 2 to 12 years Stanford-Binet Intelligence Scale, Fifth Edition - 2 to 85 years Wechsler Intelligence Scale for Children-III (WISC-III) 6 to 16 years WASI Wechsler Abbreviated Scale of Intelligence - 6 to 89 years TONI-3 the test of nonverbal intelligence 6 to 90 years SPECIFIC DOMAINS IN THE NEUROPSYCHOLOGICAL EVALUATION OF THE CHILD: Placing the dimensions of cognition into specific domains is challenging because few were intended to solely assess a specific aspect of cognitive processing or a single domain. 2

3 Language/verbal skills: Language specific basic skills include the capacity to produce phonemes, lexical development, naming and production of words, speech comprehension and linguistic aspects of writing and reading. Important language skills also include expressive and receptive components. Skills such as vocabulary definitions or applied verbal skills are included in this domain, as well. One of the many language problems that can be included in this domain is aphasia or the acquired impairment in symbolic linguistic processing not due to a perceptual disorder. Commonly Used Language Tests: Controlled Oral Word Association Test Boston Naming Test Rapid Automatized Naming and Rapid Alternating Test Token Test for Children Multilingual Aphasia Examination Peabody Picture Vocabulary Test III Expressive One Word Picture Vocabulary Test Receptive One Word Picture Vocabulary Test Visuospatial abilities: Non-verbal abilities associated with processing and manipulation of visual designs, the spatial or physical aspects of environmental objects or constructional skills. These abilities are assessed by tasks such as drawing designs, recognizing objects presented in degraded form or embedded in a more complex visual array, or assembling puzzles or block designs. Constructional tasks include motor output which requires mental manipulation of spatial information such as identification of the correct outline of an object presented in cut-up form, matching faces and angles. Commonly Used Visual Perception and Visual Construction Tests: Hooper Visual Organization Test Judgment of Line Orientation Facial Recognition Test Cortical vision Test Rey-Osterrieth Complex Figure 3

4 Attention focuses on the ability to attend to stimuli over a period of time. Tests such as Continuous Performance Tests are often used to measure this skill. The capacity to take in and report back stimuli immediately after presentation such as Forward Digit Span or Visual Pointing Span. The Stroop Color-Word Test is a brief measure of selected or focused attention. Continuous performance tests (CPT) are those tests that assess vigilance. These tests are used by neuropsychologists to differentiate ADHD from normal groups including important variables such as error of omission and commission. There are many tests to measure this domain, but the Conners Continuous Performance Test is one of the most popular among neuropsychologists. Executive function: working memory/inhibition This construct refers to both broad and very specific behaviors such as abstract reasoning, problem solving and concept formation. It measures the capacities to learn and manipulate stimuli such as Digit Span Backward, Visual Pointing Span Backward, to invoke strategies for manipulating novel stimuli. This construct also refers to the ability to acquire the "set" of new tasks and to maintain the set of a task while completing it, as well as the ability to flexibly switch from one set of task requirements to another. It requires strategic planning, impulsive control and organization. The ability to inhibit external stimuli and focusing on a specific required task is another component of this domain. Academic skills: Includes skills such as reading words or paragraphs, spelling and completing arithmetic problems. Tests used to measure this domain may include: Woodcock-Johnson-III-Tests of Achievement Specific Achievement Tests Nelson-Denny Reading Test Stanford Diagnostic Mathematics Test TOWL-3 - Test of Written Language-3 WRMT-R - Woodcock Reading Mastery Tests-Revised WRAT-R Wide Range Achievement Test- Revised 4

5 Learning and memory: Learning and memory includes different aspects of memory function. Declarative memory is generally divided into anterograde and retrograde memory function. Anterograde memory refers to the learning of new information, retention of information over shorter and longer delays, and the ability to retrieve information already in memory. This domain can be divided into verbal and visuospatial components, and is associated with dominant and nondominant memory function. This domain can be measured through presentation of stories, lists of words, designs or objects for immediate learning, with delayed recall and recognition (multiple choice) conditions. Retrograde memory refers to the capacity to remember events that have occurred or learned in the past. The tests used to measure this task include presenting famous faces, questions about historical events or facts, or questions about the child s personal history. Procedural learning and memory also called habit or skill learning refers to the capacity to learn and remember a problem-solving sequence such as reading words in a mirror or a motor skill for example driving a car. Memory and Learning Tests: Wechsler Memory Scale III (WMS-III) California Verbal Learning Test-II Wide Range Assessment of Memory and Learning (WRAML) Benton Visual Retention Test Motor skills: These abilities refer to the individual s capacity to carry out manual motor activities. They are generally assessed using the hands (manual motor dexterity), with evaluation of speed and accuracy. Tasks may be relatively simple (tapping a computer key or finger tapping apparatus), complex and requiring coordination as well as speed (pegboard tasks) or integrative (writing or typing symbols to match digits on a coding task). 5

6 Motor Tests: Grooved Pegboard Purdue Pegboard Hand dynamometer Rating Scales: Beck Anxiety Inventory Beck Depression Inventory-II Brief Psychiatric Rating Scale (BPRS) Burns Anxiety Inventory Burns Depression Inventory Children s Depression Inventory Hamilton Anxiety Rating Scale Hamilton Depression Rating Scale Inventory to Diagnose Depression Multidimensional Anxiety Scale for Children (MASC) Profile of Mood States (POMS) State-Trait Anxiety Inventory (STAI) Taylor Manifest Anxiety Scale Yale-Brown Obsessive-Compulsive Scale Connors 3 ABAS II Adaptive Behavior Assessment System Child Behavior Checklist Personality Tests: Millon Adolescent Personality Inventory (MAPI) Millon Clinical Multiaxial Personality Inventory-III (MCMI-III) Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) Minnesota Multiphasic Personality Inventory-2 (MMPI-2) NEO Personality Inventory-Revised (NEO-PI-R) Personality Assessment Inventory (PAI) Sixteen Personality Factor Questionnaire (16PF) Thematic Apperception Test (TAT) 6

7 References : Baron I.S. (2004). Neuropsychological Evaluation of the Child, Oxford. Journal of Epidemiology and Community Health (2009), 63 (Suppl 1): Assessment of neuropsychological trajectories in longitudinal population based studies in Children. Muriel D.L., Howieson, D.B., Loring D. W. (Eds.) (2004) Neuropsychological Assessment, Fourth Edition. Oxford, New York. Spreen O., Risser, A. H., Edgell, D. (eds.) (1995) Developmental Neuropsychology. Oxford University Press. Strauss, E., Sherman, M.S.E., Spreen, O. (2006). A Compendium of Neuropsychological Tests, Third Edition. Oxford University Press. 7