NEUROPSYCHOLOGICAL ASSESSMENT S A R A H R A S K I N, P H D, A B P P S A R A H B U L L A R D, P H D, A B P P

NEUROPSYCHOLOGICAL ASSESSMENT S A R A H R A S K I N, P H D, A B P P S A R A H B U L L A R D, P H D, A B P P

NEUROPSYCHOLOGICAL EXAMINATION A method of examining the brain; abnormal behavior is linked to the fxing of specific areas of the brain through the use of the psychological test neurological dysfunction is reflected in test performance

REFERRAL QUESTIONS You might be referred for a neuropsychological evaluation to: 1. find possible problems with your brain functioning, 2. form a diagnosis, 3. define your thinking skill strengths and weaknesses, 4. guide treatment for your personal, educational or vocational needs, 5. make relevant recommendations to your health care provider(s), and/or 6. document possible changes in your functioning over time.

WHAT IS A NEUROPSYCHOLOGICAL EVALUATION Attention Memory Reasoning and Problem-Solving Visual-Spatial Functions Motor Functions Academic Skills Emotional Functioning Intellectual Functioning

PSYCHOMETRIC ASSESSMENT Standardization Reliability Validity

STANDARDIZATION Procedures are completely specified for: Administration Scoring Interpretation Provides normative group

RELIABILITY Consistency or Accuracy X = T + E X = score obtained by individual T = true or actual amount of attribute that individual possesses E = amount of random error present at time of testing The less reliable the test the more it reflects error (error: ambiguous items, inconsistent instructions, etc)

RELIABILITY Equivalent Forms Test-Retest Split-Half Internal Consistency Reliability: 0 to 1.00 -------

VALIDITY Content Validity Is the test an adequate sample of the knowledge that it purports to measure? Criterion-Referenced Validity How well does the test predict performance? Construct Validity Provides information about the trait or attribute possessed by the individual.

ATTENTION Based on Sohlberg and Mateer s clinical model of attention Focused attention Sustained attention Selective attention Alternating attention Divided attention

ATTENTION PROCESS TRAINING Based on Sohlberg and Mateer s clinical model of attention Focused attention The ability to focus on specific sensory information Sustained attention Selective attention Alternating attention Divided attention

ATTENTION PROCESS TRAINING Based on Sohlberg and Mateer s clinical model of attention Focused attention Sustained attention Vigilance, persistence, mental control, working memory Selective attention Alternating attention Divided attention

ATTENTION PROCESS TRAINING Based on Sohlberg and Mateer s clinical model of attention Focused attention Sustained attention Selective attention Maintain behavioral set in the presence of distractors Alternating attention Divided attention

ATTENTION PROCESS TRAINING Based on Sohlberg and Mateer s clinical model of attention Focused attention Sustained attention Selective attention Alternating attention Shift one s focus of attention Divided attention

ATTENTION PROCESS TRAINING Based on Sohlberg and Mateer s clinical model of attention Focused attention Sustained attention Selective attention Alternating attention Divided attention Simultaneously respond to two or more stimuli

MEMORY Working Memory Encoding Storage Retrieval recall recognition

MEMORY Working Memory Holding information in mind and manipulating it Encoding Storage Retrieval recall recognition

MEMORY Working Memory Encoding Converting new information into a format that can be stored Better if processed at a deeper level Storage Retrieval recall recognition

MEMORY Working Memory Encoding Storage Placing newly acquired information into memory Retrieval recall recognition

MEMORY Working Memory Encoding Storage Retrieval Bringing stored information back into working memory recall recognition

PROSPECTIVE MEMORY (PM) Remembering a future intention

REASONING/PROBLEM SOLVING Shifting and Maintaining Set Planning Problem Solving Error Monitoring and Correction

VISUAL SPATIAL FUNCTIONS

MOTOR FUNCTIONS Finger Tapping Purdue Pegboard Grooved Pegboard

ACADEMIC FUNCTIONS Reading Writing Arithmetic Wide Range Achievement Test Gray Oral Reading Test

INTELLECTUAL FUNCTIONING

WECHSLER INTELLIGENCE SCALES Wechsler Adult Intelligence Scale 16-89 years (WAIS-III) Wechsler Intelligence Scale 6-15 years for Children (WISC-III) Wechsler Preschool and Primary 4-6 1/2 years Scale of Intelligence (WPPSI)

WECHSLER ADULT INTELLIGENCE SCALE-III (WAIS-III) Verbal Scale Vocabulary Similarities Arithmetic Digit Span Information Letter/# Seq. (O) Comprehension Performance Scale Picture Completion Digit Symbol Block Design Matrix Reasoning Symbol Search (O) Picture Arrangement

WECHSLER ADULT INTELLIGENCE SCALE-III (WAIS-III) Verbal Comprehension Perceptual Organization Vocabulary Picture Completion Similarities Block Design Information Matrix Reasoning Working Memory Digit Span Letter/Number Seq. Arithmetic Processing Speed Digit Symbol Symbol Search

EMOTIONAL PROCESSING Irritability/anger Impulsivity, frustration, perceived victimization/mistreatment/unfairness Anxiety/fear Of losing control, of uncertainty Loss/depression Inadequacy, failure, inability to achieve or maintain internal goals and expectancies All contribute to stress

TESTS OF PERSONAL ADJUSTMENT Projective Tests inkblots (Rorschach) ill-defined scenes (TAT) draw persons

MMPI/MMPI-2 Validity Scales L (Lie) F (Faking Good/Bad) K Clinical Scales Hs (Hypochon) D (Depression) Hy (Hysteria) Pd (Psych Dev) Mf (Masc/Fem) Pa (Paranoia) Pt (Psychasthenia) Sc (Schizophrenia) Ma (Hypomania) Si (Social Introvert)

TYPES OF RECOMMENDATIONS Supervision required Ability to make decisions/handle finances Safety concerns Use of compensatory devices Referrals to aid with differential diagnosis Accommodations in school or work Diet, sleep, exercise, etc.

ATTENTION

MEMORY

LANGUAGE

EXECUTIVE FUNCTIONING

VISUAL PERCEPTION

MOOD Depression Anxiety Anger