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NEUROPSYCHOLOGICAL ASSESSMENT PDF

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PDF | Neuropsychological assessments are increasingly in demand for a The range of goals that neuropsychological assessment may attain is first outlined. PDF | On Jan 1, , Roy P.C. Kessels and others published Neuropsychological Assessment. NEUROPSYCHOLOGICAL ASSESSMENT. By James F. Malec, Ph.D. Information copyrighted by authors listed and may not be photocopied for mass.


Neuropsychological Assessment Pdf

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A neuropsychological assessment looks at the functioning of the brain and is conducted by a clinical psychologist. It is not a medical procedure and does not. Neuropsychological assessment. Lisa Cipolotti, Elizabeth K Warrington. Patients with brain damage may present with impairments of memory, language, percep. NEUROPSYCHOLOGICAL. ASSESSMENT. Interview date: / /. DD. MM YYYY. @ Time started.: (24 Hour clock). Page 2 completed by coordinator. Pages 3 to

It must be remembered that the sit- ized, there is still a role to be played by NP assess- uation is often complex, since real and exaggerated ment, since it can properly evaluate and define the symptoms may coexist.

Examples are cases of mild TBI tested tions of skewed results. However, see Belanger, perform poorly for review, see Brandt, Curtiss, Demery, Lebowitz, and Vanderploeg Another approach employs tests that were specifi- for factors e. Opinions are mixed with regard , for a comparison of these two methods. Baade tion and that the tester will be employing diagnostic and Schoenberg review methods for assess- tools that might indicate suboptimal performance. Other the profoundly challenged.

There have been several clinicians have opined that such warnings may com- attempts to combine such methods using various plicate assessment and make it even more difficult weightings for an extensive review, see Lezak et al.

For the same reasons applying to premorbid esti- mates of function, it is also necessary to attempt to Downloaded by [Tel Aviv University] at To fully appreciate the significance this issue below. Design of rehabilitation programs For a thorough assessment, it is therefore neces- sary to have some indication of premorbid function. An additional goal of NP assessment is to assist Such information has implications for both rehabil- in the development of a program of rehabilita- itation strategies and for forensic issues.

Wilson b demonstrated how the ods of estimating premorbid function. No less ship between preserved subtests e. Standard reading patient how to cope with them; it also enables the tests such as the Wechsler Test of Adult Reading patient to cultivate and optimize spared abilities WTAR or the National Adult Reading Test for use as compensatory mechanisms that allow NART have also been found to index premor- adequate optimal functioning despite his or her dis- bid intellectual ability.

An alternative approach is abilities. In these tests, interventions. RBMT scores pre- to function in everyday life, in work or school.

The dicted long-term 5—10 years independent living rationale that enables us to extrapolate from per- i. It should be cognitive abilities required by relevant real-world viewed as a schematic framework presenting the situations. The model presents the various assessment situations. As can be seen in this model, there is a means available for the clinician to choose from, tradeoff between assessment that provides very spe- depending on the specificity of the question asked.

One deriva- Downloaded by [Tel Aviv University] at The interme- should be given to whether NP assessment is the diate links represent various simulated approaches optimal method for obtaining an answer. It is more to predicting performance in real-life situations. They also Reason for referral enable a greater degree of generalization than the previous instrument, at the cost of having some- Before conducting the assessment, it is impor- what lower predictive power.

As be answered. Based on those expectations, it should described above, these tests evaluate various cog- then be determined whether NP assessment is the nitive domains by using items reflecting real-life most appropriate tool to answer the questions of situations e. At the interest. For instance, for between assessment and reality. Furthermore, if the question of interest The clinical reason is that NP assessments can be is concrete and specific to a particular situation difficult and frustrating experiences for the patient.

This can save time and money i. When there is no alternative to repeated various types after an acute injury tends to be assessment, it should be postponed as long as pos- Downloaded by [Tel Aviv University] at Initially we often sible, and alternative tests or test versions should be observe dramatic improvements, but as time passes, employed whenever possible.

Several studies e.

There is no single accepted view regarding the have demonstrated effects of repetition even when period of time that passes between injury and sta- alternative versions of the same test are employed. Bond claimed that it takes 18 to It appears that patients simply learn how to take 24 months after injury until spontaneous recovery the tests more successfully.

Recently this issue has is stabilized. However, rate of recovery is depen- been examined using various approaches, involving dent on several factors such as age, location, and the use of repeated assessments to determine the severity of the injury. Generally, the most notable degree to which examinees derive benefit from prior improvements occur during the first year after exposure to the test type, as well as consistency in injury; following that time, the degree of change performance.

Therefore, NP assessment should Greiffenstein has made two very impor- generally not be performed in the initial stages of tant points regarding this issue. First, results of recovery from severe TBI—for example, while the retesting could be very informative. There may be instances when testing effort or vice versa.

Similarly, preliminary assessment the practice effect is dependent on various factors may be conducted to help plan a course of interven- such as nature of the test, severity of injury, and tion and treatment. For the purpose of long-term so on. Dikmen et al. In any inves- for NP assessment even though an assessment has tigation, one should begin by data collection and been conducted previously. For example, an insur- assessment of the correlations and contradictions ance company that does not wish to rely on a between various sources of information.

What then are the Records and documentation sources of information available to us for the pur- pose of the NP investigation? One method of controlling ties, both prior to and since the injury.

Such information tions before injury and to examine whether those allows the assessor a broader perspective on the ambitions are appropriate given his or her new consequences of the injury and can enable a more postinjury realities.

Information gathered from the balanced and comprehensive assessment. Leisure activity is performed over the course of several sessions. These kinds of information could be emotional state, cognitive abilities, and behavioral very useful in predicting the potential for future changes. It allows us to learn about his or her rehabilitation.

Evans, Sherer, tions. Behavioral changes caused by injury may Nick, Nakase-Richardson, and Yablon have also be assessed effectively by careful observa- found that impaired self-awareness was associated tion. During the course of the assessment, we can with subjective well-being in patients with TBI. This ate behaviors. It is to be noted that sivity and complete lack of initiative—for example, discrepancies between patient self-report and fam- not asking questions regarding the makeup of the ily reports are of great diagnostic value and may assessment or the time frame of the testing, or inac- serve as an important basis for recommendations tion pending explicit instructions for every action.

These have been comprehen- problems. A proposal for such a battery can be sively surveyed, by Lezak et al. Having said that, it Stuss and Levine identified two major should be remembered that brain injury might also historical approaches to NP assessment.

Diagnosis is based on norms, and classification of patients is Studies of the long-term effects of brain trauma derived from the profile of the results. In the second report a significant rise in the frequency of a range approach, the emphasis is on individual differences of psychiatric disorders among brain-injured peo- rather than norms. The tests are very flexible and ple. Koponen et al. The person up of head injuries and found that in Luria the cases the injured person subsequently suffered Luria, The Boston Process Approach sive disorders among the brain injured was These advantages of both.

On the one hand, the tests used findings exemplify the difficulty sometimes encoun- are standardized, but at the same time the assess- tered in making a differential diagnosis, since it ment is not based just on the quantitative aspects is not unusual for brain injury symptoms to be of performance but also on its qualitative aspects.

At the The focus is on the analysis of the process that led same time, it should be remembered that some the patient to the answer whether it was right or symptoms of brain injury, such as lack of initia- wrong and not looking just at the final score. In tive or disinhibition, can mistakenly be attributed to the hierarchical mediation model presented above, psychiatric causes, when in fact they reflect frontal the process approach reflects the top end of the con- lobe injuries.

In the past, it was the accepted practice to Psychosocial assessment conduct NP assessment using a fixed test battery that left little freedom of choice to the asses- Several scales have been developed in order to eval- sor.

Neuropsychological assessment of cognitive functioning following chemotherapy for breast cancer

Brain injury, espe- , the Christensen—Luria battery Christiansen, cially of the prefrontal lobes, can lead to a deficit in , or another version of batteries based on behavioral control.

Such deficits may be expressed the tests developed by A. Luria, especially in various ways. For example, Tekin and Cummings the Luria—Nebraska Neuropsychological Battery distinguished between the effects of lesions Golden et al. Today most neuropsycholo- of various prefrontal areas: Damage to the dorso- gists make use of a flexible test battery see Rabin lateral prefrontal cortex brings about disorders of et al.

Damage to the anterior cingulate gyrus cution of all everyday directed activities, and, as will lead to apathy, passivity, and lack of initiative. At the same time, request by the tester. He will not, of his own initia- all tests of attention require the involvement of tive, ask questions about the assessment e.

Therefore, atten- goals of a particular test, how long the assessment tional deficits affect performance on most tests will take. Such behavioral assessment is not based that make up the assessment. In order to con- on structured testing but relies on observation and trol for the obscuring effects of other cognitive reports by patients and their family members. Cognitive assessment There are several theoretical frameworks accord- ing to which it is possible to define the atten- Cognition is not a unitary entity, and distinctions tional components that should be assessed e.

Downloaded by [Tel Aviv University] at Attentional mea- ory in the process of assessment. Mateer mised and as a consequence what kind of tests are and Mapou have attempted an integra- the most appropriate to evaluate their components. Based on their survey, Rabin et al. For Based on earlier research on animals, Farah example, attention, construction, executive func- distinguishes between two types of deficit in tions, intelligence, language, motor skills, verbal visual processing.

Many of these subprocesses have been shown to The group of deficits in visual identification be mediated by specific brain regions. As a result, known as agnosia reflects malfunctions in the var- within the same cognitive domain some aspects may ious stages of visual object processing in the ventral be impaired while others are preserved.

Therefore, stream. Such differences may lead to the selec- arising from different levels of processing in the tion of different neuropsychological tests to assess dorsal stream. The first type is a deficit in the a given function or subprocess.

Learning and memory Abstract thinking and executive functions As is the case with the other forms of cogni- One of the most characteristic cognitive deficits tion, memory can be classified on the basis of following frontal lobe damage especially in dor- several dimensions: Bruner defined abstrac- that it enables the characterization of mnemonic tion as ability to go beyond given information, deficits in amnesia.

According to Parkin , in and, indeed, patients with frontal lobe injury char- amnesia, working memory and memory of events acteristically exhibit rigid, concrete patterns of in the distant past will be preserved, while transfer thinking.

They have difficulty in understanding of new information into long term memory will be metaphors and parables that require comprehen- Downloaded by [Tel Aviv University] at Retrieval conditions are important since they Such abstract thought is what enables us to exe- may aid characterization of memory deficits cute thought processes such as generalization and incurred as a result of frontal lobe damage.

Welsh, Pennington, Ozonoff, Rouse Variety of memory measures. Isolation of the impaired ability Such functions enable us to deal with new, unex- can be achieved by examining the copying portion pected situations for which we have no prepared of the task; a poor copy in the absence of motor solutions Shallice, Deficits in that the deficit is mnemonic rather than perceptual. One approach that can assist in Downloaded by [Tel Aviv University] at While such problems in which such strategizing is less effective such as may occur independently, interactions between memory for lists of nonwords.

Many patients experience cognitive expected on the basis of appropriate norms. The problem esteem, and, on occasions, helplessness and func- is that different individuals may obtain the same tional dependence on others. Insight into the inter- level of performance as a result of a range of abili- actions between the two kinds of deficits may accen- ties or deficits, which are not properly characterized tuate the difficulty in making differential diagnoses by the overall test results.

Researchers who became and understandably may impact on the choice of aware of this problem developed an approach that treatment. One of the best known of such methods is the Boston process approach Kaplan, Whether performance is impaired Interaction between types of cognitive or preserved, it is possible to track the process of function performance and thereby to understand the strat- egy employed by the examinee.

Every Complex Figure Test of visual memory, mentioned test comprises a number of cognitive processes. This is one of the fun- the details. Such information, which characterizes damental claims of the Boston process approach different cognitive strategies the former reflecting Kaplan, For example, poor performance left hemisphere processes and the latter right hemi- of tasks requiring memory for visual forms, such sphere processes , may not be reflected by the final as the Rey Complex Figure test, may result from performance score Kaplan, There are various versions of e.

The theoretically driven bat- the last decades in related areas of neurosciences, teries were constructed to cover a range of cog- such as neuroimaging and cognitive neuroscience. The Cambridge Neuropsychological Test sion. This battery tests visual Nevertheless, the rapid electronic technological memory, visual attention, working memory, and changes taking place in the last few decades have planning. The purpose-driven batteries are comput- already started to impact on NP assessment.

Bilder erized tests aimed primarily to be used for a specific views this change as the entrance to the third goal such as synchronizing stimuli with fMRI, or phase Neuropsychology 3. There is no doubt that the field Finally, it technology is evident: At the same time, such computerized bat- Computerized assessment teries have serious drawbacks. First of all, it could Computers have been utilized in the context of affect performance of individuals who are more as NP assessment in three different ways: Second, it is less flexible if changes are interpretation to the performance for review of required—for example, a clarification or a break.

Based on normative data, a information gained by observation of spontaneous computer can easily transform raw scores to stan- behavior is lost. Thus, by their very nature, they dard scores Luciana, There are clear advan- limit the opportunity for interaction between exam- tages in using a computer program to calculate the iner and examinee, which makes it difficult to con- standard scores.

It eliminates the potential errors duct a qualitative analysis of performance, given that could be made in the transformation.

It saves the emphasis on the final score as opposed to time and effort, and the scores speed and accuracy the process by which it is attained i. As argued above, making an assess- table or figure form, enabling the assessor to see ment solely on the basis of final scores can lead patterns and profiles of performance more clearly.

Of course, computerized systems can pro- dated the WebNeuro, which is a Web-based neu- vide valuable data about performance process—for rocognitive assessment battery. Therefore, even more pronounced here. That is, it is very diffi- the challenge is to create more flexible computer- cult to monitor the behavior of an examinee taking ized assessments that will enable involvement and the tests at a remote location.

Based on the standard scores cal- The fact that three-dimensional VR vividly sim- culated by the computer for the various raw scores, ulates the natural environment increases its eco- an interpretation of the results is offered, indicating logical validity.

At the same time, it remains in which areas tested performance is above or below a controlled setting in which various variables or in the normal range.

It could identify a profile can be recorded, controlled, and manipulated Downloaded by [Tel Aviv University] at Schultheis, programs for scoring, administration, and inter- Himelstein, and Rizzo reviewed several pretation available for pediatric neuropsychological attempts to implement VR in the assessment assessment.

Adams and Heaton point to the of a particular cognitive domain i. There have been several clinicians have opined that such warnings may com- attempts to combine such methods using various plicate assessment and make it even more difficult weightings for an extensive review, see Lezak et al.

For the same reasons applying to premorbid esti- mates of function, it is also necessary to attempt to Downloaded by [Tel Aviv University] at To fully appreciate the significance this issue below. Design of rehabilitation programs For a thorough assessment, it is therefore neces- sary to have some indication of premorbid function.

An additional goal of NP assessment is to assist Such information has implications for both rehabil- in the development of a program of rehabilita- itation strategies and for forensic issues. Wilson b demonstrated how the ods of estimating premorbid function.

No less ship between preserved subtests e. Standard reading patient how to cope with them; it also enables the tests such as the Wechsler Test of Adult Reading patient to cultivate and optimize spared abilities WTAR or the National Adult Reading Test for use as compensatory mechanisms that allow NART have also been found to index premor- adequate optimal functioning despite his or her dis- bid intellectual ability.

An alternative approach is abilities. In these tests, interventions. RBMT scores pre- to function in everyday life, in work or school. The dicted long-term 5—10 years independent living rationale that enables us to extrapolate from per- i. It should be cognitive abilities required by relevant real-world viewed as a schematic framework presenting the situations. The model presents the various assessment situations. As can be seen in this model, there is a means available for the clinician to choose from, tradeoff between assessment that provides very spe- depending on the specificity of the question asked.

One deriva- Downloaded by [Tel Aviv University] at The interme- should be given to whether NP assessment is the diate links represent various simulated approaches optimal method for obtaining an answer.

Neuropsychological Tests

It is more to predicting performance in real-life situations. They also Reason for referral enable a greater degree of generalization than the previous instrument, at the cost of having some- Before conducting the assessment, it is impor- what lower predictive power. As be answered.

Based on those expectations, it should described above, these tests evaluate various cog- then be determined whether NP assessment is the nitive domains by using items reflecting real-life most appropriate tool to answer the questions of situations e.

At the interest. For instance, for between assessment and reality. Furthermore, if the question of interest The clinical reason is that NP assessments can be is concrete and specific to a particular situation difficult and frustrating experiences for the patient. This can save time and money i. When there is no alternative to repeated various types after an acute injury tends to be assessment, it should be postponed as long as pos- Downloaded by [Tel Aviv University] at Initially we often sible, and alternative tests or test versions should be observe dramatic improvements, but as time passes, employed whenever possible.

Several studies e. There is no single accepted view regarding the have demonstrated effects of repetition even when period of time that passes between injury and sta- alternative versions of the same test are employed. Bond claimed that it takes 18 to It appears that patients simply learn how to take 24 months after injury until spontaneous recovery the tests more successfully.

Recently this issue has is stabilized. However, rate of recovery is depen- been examined using various approaches, involving dent on several factors such as age, location, and the use of repeated assessments to determine the severity of the injury. Generally, the most notable degree to which examinees derive benefit from prior improvements occur during the first year after exposure to the test type, as well as consistency in injury; following that time, the degree of change performance.

Therefore, NP assessment should Greiffenstein has made two very impor- generally not be performed in the initial stages of tant points regarding this issue. First, results of recovery from severe TBI—for example, while the retesting could be very informative. There may be instances when testing effort or vice versa.

Similarly, preliminary assessment the practice effect is dependent on various factors may be conducted to help plan a course of interven- such as nature of the test, severity of injury, and tion and treatment. For the purpose of long-term so on.

Dikmen et al. In any inves- for NP assessment even though an assessment has tigation, one should begin by data collection and been conducted previously.

Neuropsychological Assessment: Past and Future.

For example, an insur- assessment of the correlations and contradictions ance company that does not wish to rely on a between various sources of information. What then are the Records and documentation sources of information available to us for the pur- pose of the NP investigation? One method of controlling ties, both prior to and since the injury.

Such information tions before injury and to examine whether those allows the assessor a broader perspective on the ambitions are appropriate given his or her new consequences of the injury and can enable a more postinjury realities. Information gathered from the balanced and comprehensive assessment. Leisure activity is performed over the course of several sessions. These kinds of information could be emotional state, cognitive abilities, and behavioral very useful in predicting the potential for future changes.

It allows us to learn about his or her rehabilitation. Evans, Sherer, tions. Behavioral changes caused by injury may Nick, Nakase-Richardson, and Yablon have also be assessed effectively by careful observa- found that impaired self-awareness was associated tion.

During the course of the assessment, we can with subjective well-being in patients with TBI. This ate behaviors. It is to be noted that sivity and complete lack of initiative—for example, discrepancies between patient self-report and fam- not asking questions regarding the makeup of the ily reports are of great diagnostic value and may assessment or the time frame of the testing, or inac- serve as an important basis for recommendations tion pending explicit instructions for every action.

These have been comprehen- problems. A proposal for such a battery can be sively surveyed, by Lezak et al. Having said that, it Stuss and Levine identified two major should be remembered that brain injury might also historical approaches to NP assessment. Diagnosis is based on norms, and classification of patients is Studies of the long-term effects of brain trauma derived from the profile of the results. In the second report a significant rise in the frequency of a range approach, the emphasis is on individual differences of psychiatric disorders among brain-injured peo- rather than norms.

The tests are very flexible and ple. Koponen et al. The person up of head injuries and found that in Luria the cases the injured person subsequently suffered Luria, The Boston Process Approach sive disorders among the brain injured was These advantages of both.

On the one hand, the tests used findings exemplify the difficulty sometimes encoun- are standardized, but at the same time the assess- tered in making a differential diagnosis, since it ment is not based just on the quantitative aspects is not unusual for brain injury symptoms to be of performance but also on its qualitative aspects.

At the The focus is on the analysis of the process that led same time, it should be remembered that some the patient to the answer whether it was right or symptoms of brain injury, such as lack of initia- wrong and not looking just at the final score. In tive or disinhibition, can mistakenly be attributed to the hierarchical mediation model presented above, psychiatric causes, when in fact they reflect frontal the process approach reflects the top end of the con- lobe injuries.

In the past, it was the accepted practice to Psychosocial assessment conduct NP assessment using a fixed test battery that left little freedom of choice to the asses- Several scales have been developed in order to eval- sor. Brain injury, espe- , the Christensen—Luria battery Christiansen, cially of the prefrontal lobes, can lead to a deficit in , or another version of batteries based on behavioral control.

Such deficits may be expressed the tests developed by A. Luria, especially in various ways. For example, Tekin and Cummings the Luria—Nebraska Neuropsychological Battery distinguished between the effects of lesions Golden et al. Today most neuropsycholo- of various prefrontal areas: Damage to the dorso- gists make use of a flexible test battery see Rabin lateral prefrontal cortex brings about disorders of et al. Damage to the anterior cingulate gyrus cution of all everyday directed activities, and, as will lead to apathy, passivity, and lack of initiative.

At the same time, request by the tester. He will not, of his own initia- all tests of attention require the involvement of tive, ask questions about the assessment e. Therefore, atten- goals of a particular test, how long the assessment tional deficits affect performance on most tests will take. Such behavioral assessment is not based that make up the assessment. In order to con- on structured testing but relies on observation and trol for the obscuring effects of other cognitive reports by patients and their family members.

Cognitive assessment There are several theoretical frameworks accord- ing to which it is possible to define the atten- Cognition is not a unitary entity, and distinctions tional components that should be assessed e. Downloaded by [Tel Aviv University] at Attentional mea- ory in the process of assessment. Mateer mised and as a consequence what kind of tests are and Mapou have attempted an integra- the most appropriate to evaluate their components.

Based on their survey, Rabin et al. For Based on earlier research on animals, Farah example, attention, construction, executive func- distinguishes between two types of deficit in tions, intelligence, language, motor skills, verbal visual processing.

Many of these subprocesses have been shown to The group of deficits in visual identification be mediated by specific brain regions. As a result, known as agnosia reflects malfunctions in the var- within the same cognitive domain some aspects may ious stages of visual object processing in the ventral be impaired while others are preserved. Therefore, stream. Such differences may lead to the selec- arising from different levels of processing in the tion of different neuropsychological tests to assess dorsal stream.

The first type is a deficit in the a given function or subprocess. Learning and memory Abstract thinking and executive functions As is the case with the other forms of cogni- One of the most characteristic cognitive deficits tion, memory can be classified on the basis of following frontal lobe damage especially in dor- several dimensions: Bruner defined abstrac- that it enables the characterization of mnemonic tion as ability to go beyond given information, deficits in amnesia. According to Parkin , in and, indeed, patients with frontal lobe injury char- amnesia, working memory and memory of events acteristically exhibit rigid, concrete patterns of in the distant past will be preserved, while transfer thinking.

They have difficulty in understanding of new information into long term memory will be metaphors and parables that require comprehen- Downloaded by [Tel Aviv University] at Retrieval conditions are important since they Such abstract thought is what enables us to exe- may aid characterization of memory deficits cute thought processes such as generalization and incurred as a result of frontal lobe damage.

Welsh, Pennington, Ozonoff, Rouse Variety of memory measures. Isolation of the impaired ability Such functions enable us to deal with new, unex- can be achieved by examining the copying portion pected situations for which we have no prepared of the task; a poor copy in the absence of motor solutions Shallice, Deficits in that the deficit is mnemonic rather than perceptual. One approach that can assist in Downloaded by [Tel Aviv University] at While such problems in which such strategizing is less effective such as may occur independently, interactions between memory for lists of nonwords.

Many patients experience cognitive expected on the basis of appropriate norms. The problem esteem, and, on occasions, helplessness and func- is that different individuals may obtain the same tional dependence on others. Insight into the inter- level of performance as a result of a range of abili- actions between the two kinds of deficits may accen- ties or deficits, which are not properly characterized tuate the difficulty in making differential diagnoses by the overall test results.

Researchers who became and understandably may impact on the choice of aware of this problem developed an approach that treatment. One of the best known of such methods is the Boston process approach Kaplan, Whether performance is impaired Interaction between types of cognitive or preserved, it is possible to track the process of function performance and thereby to understand the strat- egy employed by the examinee.

Every Complex Figure Test of visual memory, mentioned test comprises a number of cognitive processes. This is one of the fun- the details. Such information, which characterizes damental claims of the Boston process approach different cognitive strategies the former reflecting Kaplan, For example, poor performance left hemisphere processes and the latter right hemi- of tasks requiring memory for visual forms, such sphere processes , may not be reflected by the final as the Rey Complex Figure test, may result from performance score Kaplan, There are various versions of e.

The theoretically driven bat- the last decades in related areas of neurosciences, teries were constructed to cover a range of cog- such as neuroimaging and cognitive neuroscience. The Cambridge Neuropsychological Test sion.

This battery tests visual Nevertheless, the rapid electronic technological memory, visual attention, working memory, and changes taking place in the last few decades have planning. The purpose-driven batteries are comput- already started to impact on NP assessment. Bilder erized tests aimed primarily to be used for a specific views this change as the entrance to the third goal such as synchronizing stimuli with fMRI, or phase Neuropsychology 3.

There is no doubt that the field Finally, it technology is evident: At the same time, such computerized bat- Computerized assessment teries have serious drawbacks. First of all, it could Computers have been utilized in the context of affect performance of individuals who are more as NP assessment in three different ways: Second, it is less flexible if changes are interpretation to the performance for review of required—for example, a clarification or a break.

Based on normative data, a information gained by observation of spontaneous computer can easily transform raw scores to stan- behavior is lost. Thus, by their very nature, they dard scores Luciana, There are clear advan- limit the opportunity for interaction between exam- tages in using a computer program to calculate the iner and examinee, which makes it difficult to con- standard scores.

It eliminates the potential errors duct a qualitative analysis of performance, given that could be made in the transformation. It saves the emphasis on the final score as opposed to time and effort, and the scores speed and accuracy the process by which it is attained i. As argued above, making an assess- table or figure form, enabling the assessor to see ment solely on the basis of final scores can lead patterns and profiles of performance more clearly. Of course, computerized systems can pro- dated the WebNeuro, which is a Web-based neu- vide valuable data about performance process—for rocognitive assessment battery.

Therefore, even more pronounced here. That is, it is very diffi- the challenge is to create more flexible computer- cult to monitor the behavior of an examinee taking ized assessments that will enable involvement and the tests at a remote location.

Based on the standard scores cal- The fact that three-dimensional VR vividly sim- culated by the computer for the various raw scores, ulates the natural environment increases its eco- an interpretation of the results is offered, indicating logical validity.

At the same time, it remains in which areas tested performance is above or below a controlled setting in which various variables or in the normal range. It could identify a profile can be recorded, controlled, and manipulated Downloaded by [Tel Aviv University] at Schultheis, programs for scoring, administration, and inter- Himelstein, and Rizzo reviewed several pretation available for pediatric neuropsychological attempts to implement VR in the assessment assessment.

Adams and Heaton point to the of a particular cognitive domain i. Schulenberg and Yutrzenka raised sev- In the perspective of the hierarchal model pre- eral potential ethical problems that might emerge sented above, VR simultaneously provides the ben- in the use of computerized assessment.

The poten- efits of both real-world and controlled laboratory tial of ethical problems is particularly salient in conditions. Furthermore, VR enables the person to the misuse of interpretation software by a person interact with the virtual environment, allowing a not sufficiently competent, who lacks neuropsycho- more dynamic evaluation of complex and multi- logical knowledge and training, but is nevertheless modal stimuli, which better simulate the real world tempted to use such software.

The increased trend Schultheis et al. The characteristics of VR in using computer-based tests led the American potentially allow natural transition from evalua- Psychological Association APA in to pub- tion to intervention. Although the cost of the var- ious forms of VR technology e. This review paper has from very large samples that would be stored and surveyed several aspects of assessment. Neuropsychological assessment can clarify the nature of the disorder and determine the cognitive functioning associated with a disorder.

Assessment can also allow the psychologist to understand the developmental progress of the disorder in order to predict future problems and come up with a successful treatment package. Different assessments can also determine if a patient will be at risk for a particular disorder. It is important to remember, however, that assessing a patient at one time is not enough to go ahead and continue treatment because of the changes in behavior that can occur frequently.

A patient must be retested multiple times in order to make sure that the current treatment is still the right treatment. For neuropsychological assessments, researchers discover the different areas of the brain that is damaged based on the cognitive and behavioral aspects of the patient. This allows for accurate treatment later on in the process because treatment is driven by the exact symptoms of the disorder and how a specific patient may react to different treatments.

The assessment allows the psychologist and patient to understand the severity of the deficit and to allow better decision-making by both parties. A neuropsychological assessment may show brain damage when neuroimaging has failed.

It can also determine whether the individual is faking a disorder malingering in order to attain a lesser sentence. Most neuropsychological testing can be completed in 6 to 12 hours or less. This time, however, does not include the role of the psychologist interpreting the data, scoring the test, making formulations, and writing a formal report. Neuropsychological assessments are usually conducted by doctoral-level Ph.

The definition and scope of a clinical neuropsychologist is outlined in the widely accepted Houston Conference Guidelines. Most will be licensed and practicing psychologists in their particular field.

From Wikipedia, the free encyclopedia. This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed.

Find sources: Brain regions Clinical neuropsychology Cognitive neuropsychology Cognitive neuroscience Dementia Human brain Neuroanatomy Neurophysiology Neuropsychological assessment Neuropsychological rehabilitation Traumatic brain injury.

Brain functions. Arthur L. The examples and perspective in this section deal primarily with the United States and do not represent a worldwide view of the subject. You may improve this article , discuss the issue on the talk page , or create a new article , as appropriate.The unity and diversity — Finally, mention is made of some of the difficulties and challenges that must be confronted in the course of a neuropsychological assessment.

Specific executive function application following frontal lobe damage in man. The first type is a deficit in the a given function or subprocess. Persistence of neuropsychological testing tice? In response to the wishes of the readers of our first edition, we synthesized the data in meta-analytic tables of predicted values with supporting statistics for those chapters that have sufficient number and homogeneity of studies for such analyses. Development Baade, L.

Journal Keegan, A. Geary, E.