2024 CSP Study Guide PDF

Certified Specialist in Psychometry Examination Study Guide 2024 Distributed by the Board of Certified Psychometrists 1 Contents...

Certified Specialist in Psychometry Examination Study Guide 2024 Distributed by the Board of Certified Psychometrists 1 Contents BCP Mission Statement............................................................................................3 Introduction to the CSP Examination Study Guide......................................................3  Purposes of the Study Guide.....................................................................................3 Best Practices..........................................................................................................3 Ethics.....................................................................................................................4 Principles of Ethics.......................................................................................5 Professional Limitations................................................................................5 Dual Relationships........................................................................................5 Privacy, Confidentiality, and Security.............................................................6 Informed Consent/ Release of Information (ROI)/ Disclosures...........................6 Psychometrist supervision..............................................................................7 Behavioral Observations...........................................................................................7 Diagnostic Considerations........................................................................................8 Neuroanatomy.........................................................................................................9 Cerebrum.....................................................................................................9 The Frontal Lobes.......................................................................................10 The Parietal Lobes......................................................................................11 The Temporal Lobes...................................................................................11 The Occipital Lobe......................................................................................11 Diencephalon..............................................................................................11 Midbrain (mesencephalon)...........................................................................11 Hindbrain...................................................................................................12 Medulla Oblongata......................................................................................12 Statistics...............................................................................................................12 Content Outline..........................................................................................14 Before taking the exam................................................................................15 During the exam.........................................................................................16 Sample Examination Questions...............................................................................17 Correct Answers.........................................................................................20 Terms to know for Observation...............................................................................21 Terms to know for Diagnostic Considerations...........................................................22 Tests to Study........................................................................................................24 Other terms to know...............................................................................................27 References............................................................................................................28 2 BCP Mission Statement The Board of Certified Psychometrists provides Board level certification for the profession of psychometry. By successfully completing a rigorous and comprehensive examination, Board Certified Specialists in Psychometry demonstrate the knowledge, experience, and ongoing education to administer and score psychometric measures, thereby setting the gold standard on which clinicians rely. We are dedicated to promoting and protecting the value of the Specialist in Psychometry Certification. Introduction to the CSP Examination Study Guide Psychometrists have been assisting in neurocognitive assessments since the 1930s, but until the Certification for Specialist in Psychometry, there were no clear guidelines to define and standardize the profession. The CSP credential delivers a standard identification and qualification system for psychometrists that makes clinical neuropsychology more analogous to other medical fields that utilize clinical technicians. CSPs support the standards of administration and the accurate evaluation of neurocognitive functioning. The CSP credential also serves to protect the neuropsychologists’ liability and supports court testimony in forensic cases. Purposes of the Study Guide Though Psychometrists have grown comfortable with administering tests, with the advent of the CSP Examination, the tables have been turned - quite literally – and they find themselves faced with the prospect of sitting for an examination about examining others. With this study guide, the Board of Certified Psychometrists hope to help examinees understand what should be studied to succeed in passing the CSP examination. It will not provide the specific information, but instead help direct a person in their individual study efforts. The CSP examination was created by psychometrists for psychometrists and is designed to reflect the level of competency required to responsibly practice the profession. The principal goal of the Certified Specialist in Psychometry is to ensure that the psychometrist is knowledgeable and can competently administer and score the assessments deemed necessary by the neuropsychologist. Historically, the most challenging areas for CSP examinees have been Ethics/Legal, Statistics, and Neuroanatomy. To avoid confusion, in this Study Guide, we will be using the terms Patient/Client to describe the person to whom the psychometrist is administering an assessment measure, and Examinee in reference to those who are sitting for their CSP exam. Best Practices The principal goal of the psychometrist is to competently administer and score the assessments deemed necessary by the clinician and get the best effort possible from the patient. The following concepts are examples of Best Practices and expected to be used as standard operating procedures except in cases where a professional judgment call is made (such as if a person does not understand the official protocol; it should be reworded and explained as needed as per guidelines in the manual for that test). 3 Psychometrists must establish and maintain rapport with clients as well as keep detailed observations of the clients’ behaviors during testing. The neuropsychologist will require a detailed behavioral observation  sheet in order to be able to interpret variable behaviors during testing that may influence the testing results. These standardized expectations are required to ensure that education, training and supervision of psychometrists are the same across the field (The Use of Neuropsychology Test Technicians in Clinical Practice, 2000). Ensure the client is prepared for the assessment (i.e., note whether they are hungry, tired, on their prescribed medications or using narcotic medications). The first part of your interaction with the client should include introductory statements. Next, talk to the client about the expected length of the assessment, provide information regarding when breaks will be taken, where the restrooms or other amenities are located, and what to do in case of an emergency. It is imperative that the psychometrist maintains notes that supply information about the client’s performance, behaviors, and responses (see Behavioral Observations section). There are significant variables in the client’s behavioral observations that may very well affect the provider’s findings. Carefully consider the order of administration of tests. Ensure the placement of tests that show order of administration effects (i.e. WCST, Category Test) are in optimal positioning. Additionally, planning is required in order to avoid test interference. Avoid filling in delays with tasks that have similar visual or verbal content. Constructive and encouraging feedback such as “Remember, I just want you to give your best effort. It’s ok not to know all the answers as long as you try your best” or “I know it’s hard, but if the test doesn’t push you past your limits, we won’t be able to find them” often help reduce stress or worry the client has about their performance. Alleviate the client’s testing anxiety as much as possible to avoid ceiling effects; however, be careful not to make comments that in any way suggest an interpretation of the patient’s performance. The testing environment should be comfortable, well lit, not too hot or cold, and minimize distractions as much as possible. Provide comfortable chairs and breaks as necessary. It is advised that testing breaks be provided after 1.5 hours of testing or more often if deemed necessary. Consider the reason for the testing referral when setting up your testing room such as making sure that a patient with a history of seizures is seated in a chair with arms that is not on wheels. Whenever possible, always use the script provided by the creators of the test so that validity of the administration is protected. Ethics Decisions regarding ethical questions can be some of the most harrowing a psychometrist will encounter in their career. It can be especially difficult to make ethical decisions when they require you to take action that is opposed to the standard procedures of a practice. The first and best way to deal with these problems is to know what those ethical standards are. Ethics and the law are not the same thing, and it is important to know the difference between the Standards as they apply to psychometry. The fact that something is legal does not automatically make it ethical. Legal Standards are based upon written law. Ethical Standards are a set of moral principles that govern a person’s behavior or the conducting of an activity based upon the human principles of right and wrong. To understand ethical standards, you should be thoroughly familiar with the Code of Ethics standards from BCP, NAP, APA, ACA, and NBCC. 4  Regulations vary by setting: Clinical – each institution may have their own regulations you must follow Research – IRB guidelines Forensic Rehabilitation - Acute, Long-term, and community Child assessment - age of consent, custodial parent, guardianship, school assessments Older Adults- questions of competency, ability to give consent Psychiatric Units Private Practice Military Educational/vocational Third party observers Principles of Ethics Beneficence and Non-malfeasance – take care to do no harm. Fidelity and Responsibility – uphold professional standards of conduct, accept responsibility for your behavior, and seek to manage conflicts of interest. Integrity – promote accuracy, honesty, and truthfulness in the science, teaching and practice of psychology. Justice – all persons are entitled to access and benefit from the contributions of psychology. Autonomy and Respect for People’s Rights and Dignity- privacy, confidentiality, and self determination. Professional Limitations Psychometrists must recognize the limits of their profession and not attempt to practice outside the scope of their expertise. One of the most important and frequently encountered problems occur when patients ask questions regarding their progress or results. Psychometrists should make it clear that they cannot give the patient that information and encourage the patient to continue to give their best effort on all tasks. The psychometrist should explain that the neuropsychologist will interpret the tests and provide feedback. Psychometrists must not interpret results of instruments unless interpretation is a designated aspect of a specific job and the Psychometrist meets all state and local licensing requirements. Licensure and Certification are commonly confused terms, and you should understand the difference between them. The CSP is a certification, not a license. Licensure is legal authority granted by the state to practice one’s profession within a designated scope of practice. Certification is typically a voluntary process provided by an organization with the intent of providing public protection by recognizing individuals who have successfully met all the necessary requirements and demonstrated their ability to perform their profession competently. Dual Relationships Psychometrists who have an administrative, supervisory, and/or personal relationship with individuals seeking testing services must not serve as the Psychometrist and should refer the individuals to other professionals. The 5 psychometry relationship remains confidential. Psychometrists must not engage in activities that seek to meet their personal or professional needs at the expense of the patient. Sexual intimacy with patients is unethical. Psychometrists will not be sexually, physically, or romantically intimate with patients/clients or former patients/clients within a minimum of two years after terminating the Psychometry relationship. Privacy, Confidentiality, and Security Privacy is the freedom and ability to control the use and dissemination of information that relates to oneself, and Confidentiality is the primary tool for protecting privacy. Those handling confidential information must adhere to strict legal and ethical limitations governing access and disclosure. Security is comprised of the measures an organization employs to protect the confidentiality of both patient and test information. However, confidentiality can sometimes be waived without signed consent of the patient: Court order/forensic evaluations/workman’s compensation – In these cases, the client is often the court, the attorneys, or another third party. The client is not always the patient. The person paying for the evaluation is the client. Parents or legal guardians of a minor Suspected abuse of child or vulnerable adult – mandated reporters – In all US states there are mandates that professionals are required to report suspected cases of child abuse. If a psychometrist does not report these cases, legal action can be taken against the psychometrist, the supervising licensed psychologist and the facility. Peer review, accreditation, quality assurance- Records may be reviewed by outside agencies in certain cases. Clear and imminent danger to themselves – If the psychometrist believes the patient is in danger of harming themselves, it is incumbent upon the psychometrist to intervene by breaching confidentiality and taking appropriate action to ensure the safety of the patient. Many times this is done by bringing in the licensed psychologist to further assess the situation and make the appropriate judgement on next steps. Depending on your setting and protocols, psychosocial measure should be checked for suicidality while the patient is still present, if possible, so that it can be addressed with the patient before they leave. Danger to others – Duty to warn; be familiar with the Tarasoff case. All medical and mental health personnel have a duty to warn those who are at risk of danger from a patient. The duty includes contacting the intended victim, their family, the police or taking other steps to safeguard the intended victim and document the steps taken, including attempts to consult with the supervising licensed psychologist and/or applicable facility administrator. Informed Consent/ Release of Information (ROI)/ Disclosures In both clinical and research settings, the concept of informed consent is vital to disclosing the risks and benefits associated with a procedure or a set of procedures. The main purpose of informed consent is to ensure that the researcher or practitioner adhere to and uphold the five Principles of Ethics in their particular activity. 1. Patients should be informed of the purpose of the evaluation or research 2. Their right to decline to participate or to withdraw at any time 3. The foreseeable consequences of declining or withdrawing 4. Any prospective benefits 5. The limits of confidentiality A release of information (ROI) is a document detailing to whom confidential information concerning the patient may be disclosed to. It is also necessary to notify the patient of when confidentially must be breached such as instances of danger or abuse to self or others.  6 Psychometrist supervision Psychometrists may be supervised by more experienced Psychometrists, but ultimate responsibility for the psychometric services is the responsibility of the supervising Psychologists/Neuropsychologists who meet all state and local licensing laws. Behavioral Observations As psychometrists, one of our many responsibilities is to observe the patient throughout the testing process and report our observations to the clinician. A patient's behavior will likely fluctuate during a testing session due to fatigue, medication half-life, difficulty level or dislike of a task, etc. It is therefore possible to have multiple or conflicting observations regarding patient behaviors. It is important to note the duration of testing for billing and reporting purposes. Here are some things to consider when noting observations. There is also a worksheet on page 21 that lists terms you should know for observation with space to take notes while preparing for the exam. General Presentation and Appearance Was the patient accompanied by anyone, if so by whom? (parent, grandparent, etc.) What time did they arrive? (on time, early, late) What was their arousal like? (alert, drowsy, etc.) How is their hygiene and grooming? (odor, unwashed, etc.) What is their physical stature? (weight, physical anomalies, etc.) Do they require or use adaptive equipment? (glasses, hearing aid, walker, etc.) Did the patient take their medication on the test date? Had the patient eaten? Waiting Room Behavior How did the patient interact with those who accompanied them? How did they behave while waiting? (interacted, read, slept, etc.) Did they separate easily from whomever accompanied them? Did they transition easily back to testing after taking a break? Social Interaction, Affect, Behavior, and Attention How easy was it to build rapport with the patient? How was the patient's eye contact during testing? What was the patient's interaction style like? (inappropriate, whining, pleasant, etc.) Was their behavior age-appropriate? Based on facial expressions and body language (concrete, observable behaviors), what is the patient's emotional tone like? (euphoric, anxious, irritable, etc.). Was the patient cooperative? What was their activity level like during testing? (fidgety, very little movement, etc.) What was their attention span like during testing? (focused, distracted, etc.) How often and during which tasks did the patient complain?  Was the patient in any pain during testing? If so, what kind and what was done to mitigate this? Working Style What is the patient's task initiation like? (impulsive, needed extra prompts, etc.) 7 What is the patient's approach to the tasks? (indifferent, perfectionistic, impulsive, etc.) What is their working pace like? What is the patient's response to success and failure? How does the patient respond to tasks that were challenging or frustrating? Does the patient exhibit any task avoidance? Does the patient give good effort? (If not, is a validity test performed?) Language/Communication How are the patient's listening skills? How well does the patient comprehend instructions? How is the patient's expressive language (speech)? (too fast/slow, slurred, too loud/soft, articulation errors, etc.) How is their verbal expression/production fluency? (goal directed, single word phrases, word finding problems, etc.) Sensory/Motor How is the patient's hearing? How is the patient's vision? How is their pencil grip? (mature, dynamic tripod, static tripod, wrist/arm not integrated in movement, etc.) How are their fine motor skills? (writing, manipulation of testing materials, etc.) How are their gross motor skills? (gait, posture, balance, etc.) Are there any tremors? If so, when were they most noticeable? Were they bilateral? Other Were any behavior management strategies used and if so how effective were they? (redirection, reinforcement, extra breaks, etc.) What else is noteworthy about the patient that wasn't already mentioned? Overall how did the testing session go? List any abnormal behaviors List any unusual comments Diagnostic Considerations An integral part of making observations is to be alert for symptoms of already diagnosed diseases/injuries. Many diseases/disorders/injuries (epilepsy, ADHD, Parkinson's, anxiety, oppositional defiance, autism, etc.) have distinctive symptoms, and it is the psychometrist’s responsibility to recognize these and report on their severity and frequency. For instance, there are times when the patient may seem to “zone out,” which could be due to something as typical as inattention or as critical as an absence seizure. You should also be aware of the proper procedures in the event of more intense symptomatic behaviors such as grand mal seizures. At times, seizures can present in unusual ways, such as laughing, so it is helpful to ask the patient or their guardian/support person what their specific seizures look like. Make note of times, duration, and preceding events if a seizure is observed along with obtaining the appropriate medical intervention if needed. A psychometrist should never use observed behaviors to attempt to diagnose a patient or to interpret any responses or results. Diagnosis and interpretation is the duty of the clinician, not the psychometrist. Instead, 8 they should make detailed observations that will assist the clinician in making those leaps. One example of this would be ignoring stimulus presented on one side of the visual field. There is also a worksheet on pages 22-23 that lists terms you should know for diagnostic considerations with space to take notes while preparing for the exam. Neuroanatomy Neuroanatomy is essentially the part of anatomy dealing with the nervous system, where the nervous system is comprised of nerves, the brain, spinal cord, and ganglia (a mass of nerve tissue existing outside the central nervous system). This section will focus primarily on the neuroanatomy of the brain. The brain consists of five parts based on embryotic development: the cerebrum, diencephalon, midbrain, hindbrain, and the medulla oblongata. The brain stem is comprised of the last three of these parts. Cerebrum The cerebrum is made up of two layers. The thin, gray outer layer, called the cortex, consists primarily of cell bodies. The white inner layer consists of myelinated axons and is where the hippocampus and basal ganglia may be found. The cerebrum is also made up of two hemispheres: the Left and the Right. Though embedded within the white matter, the basal ganglia do not consist of white matter. It is a collection of four gray matter nuclei and is associated with motor control. The hippocampus is a major component of the memory system and plays a major role in normal learning and retention. “The hippocampus is well-designed for rapid association of information from many different cortical areas.” The two hemispheres of the brain are connected to each other by a C-shaped structure called the corpus callosum. They each have their own general, though not necessarily exclusive, functions. The table below shows the general functions of the Left and Right hemispheres typical of a right-hand dominant individual. Left-handed and ambidextrous individuals may have slight differences. Note that the Left hemisphere involves mostly language abilities while the Right hemisphere involves primarily nonverbal abilities. Left Hemisphere GENERAL FUNCTION Right Hemisphere geometric patterns faces words emotional expression letters VISION language sounds HEARING non-language sounds music  verbal memory MEMORY nonverbal memory speech grammar rules reading arithmetic writing LANGUAGE emotional tone of speech 9 sense of direction distance SPATIAL ABILITY mental rotation of shapes geometry Each hemisphere is divided into four regions or lobes: frontal, parietal, temporal, and occipital. The graphic below lists the functions of the lobes as well as the Cerebellum and Brain Stem. It was taken from a presentation on rehabilitation through Pearson. The Frontal Lobes Through the evolution of the human brain, the frontal lobes have developed most recently and have become the largest structure of the brain. They are often considered to house the “highest” and most complex human brain functions. Damage to the frontal lobe often leads to disruptions in cognitive and social behaviors. The following is a list of some of the common functions of the frontal lobes: “Consciousness” or awareness of what we are doing in our environment Involvement of how we initiate activity in response to our environment Judgment and decision-making Control of expressive language 10 Assignment of meaning to chosen words Involvement in word associations Mediation of movements Memory for habits and motor activities Broca’s area is located in the dominant hemisphere of the frontal lobe. The main output of Broca’s area is to the face and tongue areas of the adjacent motor cortex. Therefore, it is associated with expressive language, or the ability to get one’s words out. The Parietal Lobes The parietal lobes are generally concerned with spatial relationships (right parietal lobe, predominantly) and with the initiation of movement (left parietal lobe, predominantly). They have also been found to be involved with body schema, which is an individual’s spatial awareness of his/her body parts. Other functions of the parietal lobes include perception of touch, visual attention, and the integration of senses to understand a single concept. The Temporal Lobes The temporal lobes contain the primary auditory cortex and are associated with spoken language for they contain Wernicke’s area. Wernicke’s area, in contrast to Broca’s area, is associated with receptive language, or the ability to understand spoken words. Though both areas are larger in the left hemisphere, both areas are simultaneously active in the right hemisphere. These right-side areas are believed to be concerned with prosody – the recognition of rhythmic effects of spoken language like cadence, volume, and emphasis, for example. The temporal lobes also play a role in auditory memory and complex perceptual organization. The Occipital Lobe The occipital lobes contains the primary visual cortex. Diencephalon The diencephalon is comprised of the thalamus, hypothalamus, and epithalamus. The thalamus is the nervous system’s main sensory relay. The hypothalamus is key to controlling the autonomic nervous system, emotional states, and acts as the body’s thermostat. The epithalamus has multiple components, only two of which will be mentioned here. One component is the pineal gland, which affects daily and seasonal body rhythms by the secretion of melatonin. The regulation of hunger and thirst is accomplished through another component of the epithalamus – the habenula. Midbrain (mesencephalon) The midbrain serves important functions in motor movement, particularly movements of the eye, and in auditory and visual processing. 11 Hindbrain The cerebellum is the most noticeable part of the hindbrain and, with the basal ganglia, helps with coordinating and learning skilled movements. Also, by receiving information from the structures and sensors in the middle ear, it plays a role in maintaining one’s equilibrium. Another part of the hindbrain is the reticular formation, also known as the reticular activation system. It is believed to play the role of maintaining general arousal or consciousness. Medulla Oblongata The medulla oblongata is the most primitive part of the brain. It is the control center for our basic life-support systems: respiration, blood pressure, heartbeat, etc. Statistics Because working as a Psychometrist involves quantifying things that are otherwise difficult to measure, it is important to have at least a rudimentary grasp of statistics. Most tests provide raw scores which must be converted to Standard Scores before the information can be useful. Below is a chart taken from Essentials of Testing & Assessment by Neukrug and Fawcett to provide a visual reference of different types of scores and how they relate. 12 Average: Mean: obtained by adding a set of numbers and dividing by the numbers added o (ex. 10+5+15+10=40 then 40/4=10 is the mean) Mode: The most commonly occurring number from a set of numbers o (ex. of 10+5+15+10, because 10 is listed twice, 10 is the mode)  Median: The middle value when a list of numbers is written in numeric order o (ex. 5, 10, 10, 15, because 10 is in the middle, 10 is the median) Error Variance: Indicates how much random fluctuation is expected within scores and often forms part of the denominator of test statistics. Confidence Interval: A range of values so defined that there is a specified probability that the true value of a parameter lies within it. Percentile: A percentile score gives the percent of people who fall at or below a score. Raw Score: The untreated score, before being manipulated into a Standard Score as is done for all norm referenced tests. Scaled Score: A scaled score is a raw score that has been converted onto a consistent and standardized scale. Standard Score: Is derived by converting the raw score to a score that has a new mean and standard deviation. Standard Deviation: A measure of variability that describes a score’s distance from the mean. The Standard Deviation is the square root of the Variance. Stanine (Standard Nine): A standard score with the mean of 5 and a Standard Deviation of 2. Sten Score (Standard Ten): A standard score with the mean of 5.5 and a Standard Deviation of 2. T-Score: A T-Score has a mean of 50 and a Standard Deviation of 10. A T-Score is converted from a Z-Score by multiplying the Z-score by 10 and adding 50. Z-Score: A Z-Score has a mean of 0 and a Standard Deviation of 1. It is calculated by subtracting the mean from the raw score and dividing that answer by the standard deviation. (ex. raw score =15, mean = 10, standard deviation = 4. Therefore 15 minus 10 equals 5. 5 divided by 4 equals 1.25. Thus the z-score is 1.25.) Standard Error of Measurement: Refers to the test, not the client. It is derived by taking the square root of 1 minus the reliability and multiplying that number by the standard deviation of the desired score. Regression to the Mean: Refers to scores of an individual getting closer to the mean score over time. This could be either raising or lowering a score as long as it gets closer to the mean score of the test. Reliability Co-efficient: A measure of the accuracy of a test or measuring instrument obtained by measuring the same individuals twice and computing the correlation of the two sets of measures. 13 CSP Exam Tips and Suggestions Remember that the test will cover all populations and conditions.  You are being certified for proficiency in your profession, not proficiency in your job. Content Outline The following is a detailed outline of the four major content areas of the examination, with an indication (in parentheses) of the approximate percentage of the examination devoted to each area. I. Pre-testing (18%) Review patient records to obtain information on how to proceed with evaluation. Prepare testing environment to ensure patient safety and maintain standardization. Gross neuroanatomy. Review test materials and manuals needed to prepare for the administration. Interview patient to obtain background information, determine readiness for testing, establish rapport, confirm appropriateness of tests selected; prepare patient and family for the evaluation (e.g., purpose, duration, process). II. Test Administration (55%) Knowledge of the administration and scoring of tests in a standardized manner to validly perform and execute planned evaluation. Monitor patient performance and behavior to determine need for modification to planned evaluation. Monitor patient safety to protect patient and Psychometrist. Score tests to obtain results of the evaluation. Record behavioral observations to provide additional data and validity for the evaluation. III. Post-Testing (22%) Convert raw data to normative data to provide information for interpretation and statistical comparisons. Review integral behavioral observations and test observations data to provide information and recommendations for interpretation. IV. Ethical / Professional / Legal Issues (5%) Psychometrists practice their profession in an objective manner consistent with applicable published codes of ethics. They protect patient confidentiality and the security of tests and copyrighted materials. 14 Before taking the exam  Study well in advance and in small increments. Cramming is not an effective study method. If you have never hand-scored the WAIS/WMS, WCST, MMPI, etc. please do so to better your understanding of the scoring process. Know what tests purport to measure and to which age group they are appropriate. Form a study group with other psychometrists. Know the difference between the standard testing procedure for the exam and the procedures you may use in your office. The exam will only cover standard testing procedures, not variations that are not part of the test manual. Study the Code of Ethics for Certified Specialists in Psychometry, the APA Code of Ethics, the Code of Ethics by the NBCC and the ACA Code of Ethics. Understand their intent and how they apply to psychometry. Study neuroanatomy no further than understanding the primary regions of the brain – such as the lobes. Understand how each lobe contributes to human brain functioning as well as which tests lateralize to these regions. You will not need to know statistical formulas, but you do need to know how scores relate. (comparing a standard score to a T-score, etc.) Use a mnemonic to remember more difficult things. (left = language, temporal = time, etc.) There are no trick questions; however, you should be alert for phrasing such as always, only, and never. Every psychometrist surveyed administers/scores the WAIS and/or WISC, so you are guaranteed to have questions regarding these measures on the exam. Understand the subtests and indices and know their acronyms. You should also know which subtests load on which indices and what substitutions are permitted per the manual. The more obscure tests may not even be on your exam. Focus on the better-known measures but try to have a general knowledge of all tests on this list. The worksheet included on pages 24-26 in this study guide can be helpful to gather basic information on each exam. Understand the use of the Revised Comprehensive Norms for the Halstead Reitan Battery for calculating education level. Education level calculation is something we need to do, and the HRB is a good source for guidelines on this. The following information was taken from A Compendium of Neuropsychological Tests. Counted in Years of Education: Only full years of regular academic coursework that are successfully completed are counted Regular college or university Not Counted in Years of Education: Years in which person obtained failing grades are not counted Partial years are not counted General Equivalency Diploma (GED) is not counted Vocational training is not counted No matter how much time it takes High School = 12 to complete a diploma or degree, Associate’s Degree = 14 standard numbers of education Bachelor’s Degree = 16 years are assigned: Master’s Degree = 18 Doctoral Degree = 20 Use the worksheets at the end of this study guide to aid you in your studying. While these worksheets do not list every term/test that may be on the exam, they are a good base of knowledge to have going into the exam and will help you to be more successful. Writing things yourself has been proven to be a better  learning strategy than simply reading materials. 15 During the exam Have a healthy breakfast before the exam – but not too heavy as this may cause a paradoxical effect making you drowsy. Make sure your computer is fully charged and has an adequate internet connection. If taking an in-person electronic exam. arrive early, on-time at the latest. If taking a remote exam, be sure to log-in early enough to follow pre-testing procedures that you are sent via e-mail. Get seated and comfortable in your seat/location. Use the restroom before the doors close if in person and before beginning your exam if remote. Read each question and answer it in its entirety. Do not read too much into the question – but make sure you understand what is being asked. In general, answer ethical questions in terms of protecting the patient. There is no penalty for guessing. If there is a line through the number of the question, it means you answered the questions. If it is still white with no line, you did not answer it. You will have an option to “review” a question later by clicking the review button. This will highlight the question so you can go back to it before submitting your exam. Try restating a question in your own words to better understand what is being asked. Answer in terms of how tests should be administered and scored per the manual and not only as they are administered in your setting. Try not to second-guess the intent of the question – the item was written by a psychometrist just like you. Expect there to be questions you do not know. Take your best educated guess on those items. There are no “all of the above,” “none of the above,” or True/False answer choices – only A, B, C or D. On long questions, read the answers first. Take the full time available if needed. The time remaining for your exam will be displayed in the upper corner of your screen during the exam. Keep hydrated. Bottled water is allowed in the exam room both in person and remotely Wear layers so you can adjust your temperature to the room environment as it may vary. Use ear plugs if necessary for in person exams There is nothing allowed in your ear for remote exams except for hearing aids. Be sure to read the rules about what is/is not allowed in the testing room. You are not allowed to have any paper (including blank paper), books, phones, smart watches, rulers, calculators, pens or pencils in your testing space. This will be checked prior to you being allowed to begin the exam. If you are found to be in violation of any exam taking rules, your exam could be ended by the proctor and your test scores will be voided without refund.  16 Sample Examination Questions (Disclaimer: These items are representative of the types of items found on the examination but not necessarily representative of overall examination content. Some items may have been on the exam in the past and are retired items.) 1) Upon the completion of testing, the client asks you for feedback regarding performance and/or diagnosis. Your best response is to: a. inform the client that the supervising psychologist will provide feedback. b. reassure the client and indicate that test performance was “fine.” c. provide a provisional diagnosis but defer interpretation and recommendations to the supervising psychologist. d. provide interpretive information on the client's performance but defer diagnosis to the supervising psychologist. 2) A score from a distribution with a mean of 50 and a standard deviation of 10 is called a: a. z-score. b. T-score. c. stanine score. d. scaled score. 3) Anomia, the impaired ability to name objects or retrieve words, is a form of: a. anoxia. b. ataxia. c. aphasia. d. apraxia. 4) When assessing a patient with a history of frontal lobe injury, you can expect the patient to be: a. paraphasic, confused, and disoriented. b. overly cooperative, docile, and passive.  c. selectively mute, inattentive, and indecisive. d. disinhibited, easily frustrated, and inflexible. 5) A patient you are testing is constantly distracted and interrupts you, saying things like “That reminds me of the time…,” or “Let me tell you a story about that.” This behavior is best described as: a. tangential. b. perseverative. c. intrusional. d. distractible. 17 6) When administering a list-learning task, the patient reports a word that is not on the target list. What type of error is this? a. Perseveration b. Intrusion c. Substitution d. Insertion 7) If a research study includes a population in which the potential subject may not have sufficient decisional capacity to provide informed consent, what should the investigator do prior to enrolling the participant? a. Discuss the study with the family and have the family/guardian consent for the participant b. Use an Investigational Review Board (IRB) approved process for assessing and documenting capacity and obtaining surrogate consent c. Get a second opinion from a qualified investigator to agree that the participant meets study criteria d. Assess capacity and only enroll subjects who have sufficient capacity to provide informed consent 8) Informed consent requires all of the following EXCEPT: a. Being informed of both positive and negative consequences b. Being informed of negative consequences c. Establishing mental sanity and/or competence d. Giving consent voluntarily 9) The test format with the least reliability is: a. Essay b. True – False c. Multiple choice d. Fill in the blank 10) A psychometrist should know a patient's hand dominance because:  a. You would expect a difference in hand strength b. It may determine which hand to use first on a particular task c. You would expect no difference in hand strength d. It does not matter; hand dominance has no influence on the test administration 11) Best practices regarding use of clinical terminology during an interview and testing state: a. Use it discriminately if you feel it will add value to the assessment b. Use it often, especially with intelligent clients c. Never use it d. Minimize its use 18 12) Pseudoseizures are more closely related to: a. Blatant malingering b. Anti-convulsant toxicity c. Fronto-temporal generalized seizures d. Conversion disorders 13) A personality change from a brain injury is most commonly associated with which lobe? a. Frontal b. Temporal c. Parietal d. Occipital 14) The administration rules of some tests allow psychometrists to begin with items other than the first one. What is one reason for this procedure? a. The hardest items can be dealt with first. b. It shortens testing time. c. It establishes rapport. d. It motivates the patient. 15) Maximal is to typical as: a. Personality is to IQ b. Feeling is to performance c. IQ is to personality d. Best is to effort 16) Which WAIS-IV subtest is most sensitive to the effects of aging?  a. Similarities b. Letter-Number sequencing c. Information d. Digit Span Forward 17) Which measure is appropriate to administer after the last immediate recall trial of a verbal list learning task? a. DKEFS or RUFF Verbal Fluency Test b. Phonological Processing (NEPSY-II) or COWAT c. CPT-3 or CATA d. WAIS-IV Vocabulary or WTAR 18) On a naming task, if the patient responds to an item that is a chair stating it is a "couch" this response is a: a. phonemic paraphasia. b. circumlocution. c. semantic paraphasia. d. neologism. 19 19) The ______________ is located under the skull and is a thick and durable membrane containing a double layer of connective tissue. a. arachnoid b. pia c. dura d. brain stem 20) The WCST and CAT are measures of: a. cognitive functioning. b. executive functioning. c. tactile skills. d. visual perception. Correct Answers: 1) a, 2) b, 3) c, 4) d, 5) a, 6) b, 7) b, 8) c, 9) b, 10) b, 11) d, 12) d, 13) a, 14) b, 15) c, 16) b, 17) c, 18) c, 19) c, 20) b  20 Terms to know for Observation TERM NOTES Affect Agraphia/dysgraphia Acalculia/dyscalculia Circumlocution Cochlear implant Confabulation Dysarthria Dysnomia Dyspraxia Echolalia Intrusion Malingering Mania/hypomania Micrographia Neologism Paraphasia Perseveration Practice effect Pressured Speech Primacy Effect Prosody Recency effect Response Bias Response latency Semantic cluster Spoiled Response Telegraphic speech 21 Terms to know for Diagnostic Considerations TERM NOTES ADD/ADHD Akinesia/dyskinesia Alexia Alzheimer's Amnesia Anhedonia Aneurysm/embolism Aphasia/dysphasia Asperger’s Ataxia Autism Bradykinesia Cerebral Palsy Cerebrovascular Accident/Stroke Dementia Down's Syndrome Encephalopathy Epilepsy Fetal Alcohol Syndrome Hemianopia Hemineglect Hemiparetic Histrionic Intellectual Disability Korsakoff Syndrome Learning Disability Lesions 22 Multiple Sclerosis Organic Brain Syndrome Orthostatic Hypotension Parkinson's disease Premorbid Prosopagnosia Schizophrenia Seizures Absence Grand Mal Tonic A-Tonic Tangential speech Telegraphic speech Tremor Intentional  Resting Shaken Baby Syndrome Sundown Syndrome Tardive Dyskinesia Tourette’s Syndrome Tics Vocal Fine motor Gross motor Traumatic brain injury Visual agnosia 23 Tests to Study It will be important to know: Tests by their acronyms Test functions and age range Abbreviations for the subtests and indices on the Weschler tests The difference between Aptitude tests and Achievement Tests Below are some tests that may be on the CSP examination. This is not an exhaustive list. Make sure to study the current version of these tests. TEST NAME/ACRONYM AGE NOTES RANGE Advanced Clinical Solutions (ACS) Social Cognition Effort Test of Premorbid Functioning (ToPF) Aphasia Screening Test (AST) Bayley Scales of Infant Development (BSID) Beck Anxiety Inventory (BAI) Beck Depression Inventory - (BDI) Boston Naming Test (BNT) California Verbal Learning Test (CVLT) Category Test (CT) & Booklet Category Test (BCT) Child Behavior Checklist (CBC) (a.k.a. Achenbach) Children’s Trailmaking Test (CTT) Clock Drawing Test and Draw A Flower Test Continuous Performance Test (CPT) Controlled Oral Word Association Test (COWAT / COWA) Delis-Kaplan Executive Functioning Scale (DKEFS) Dementia Rating Scale (DRS) Dot Counting Test (DCT) Facial Recognition Test (FRT) Geriatric Depression Scale (GDS) Grip Strength (Dynamometer) 24 TEST NAME/ACRONYM AGE NOTES RANGE Grooved Pegboard Test (GPT) Halstead-Reitan Neuropsychological Test Battery (HRB) – Adult, Older Children & Younger Children Finger Tapping Test Lateral Dominance Test Rhythm Test - Seashore version Sensory Perceptual Exam Speech Perception Test (SPT) Tactile Form Recognition Test (TFR) Tactual Performance (TPT) - children through adult Hooper Visual Organization Test (HVOT) Judgment of Line Orientation Test (JOLO) Memorization of 15-items (aka Rey 15-Item Memory Test; Rey’s Memory Test) (RMT) Millon Clinical Multiaxial Inventory - (MCMI) Mini Mental Status Exam (MMSE) Minnesota Multiphasic Personality Inventory - (MMPI-2 / MMPI-A)(+RF) Montreal Cognitive Assessment (MoCA) Nelson-Denny Reading Test North American Adult Reading Test - Revised (NARTR; NAART) Paced Auditory Serial Addition Test - (PASAT) Peabody Picture Vocabulary Test - (PPVT) Personality Assessment Inventory (PAI) Ravens Progressive Matrices (RPM) Recognition Memory Test (RMT) – aka Warrington Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Rey Auditory Verbal Learning Test (RAVLT) Rey-Osterrieth Complex Figure Test (RCF or RCFT) - including Taylor version Rorschach 25 TEST NAME/ACRONYM AGE NOTES RANGE Smell Identification Test (UPSIT / SIT) Stanford-Binet (SB) State-Trait Anxiety Inventory (STAI) Stroop Symbol Digit Modalities Test (SDMT) Test of Memory Malingering (TOMM) Test of Nonverbal Intelligence (TONI) Tokens Test (TT) Trail Making Test (TMT) - color, adult, and intermediate Victoria Symptom Validity Test (VSVT) Vineland Adaptive Behavior Scales (VABS) Visual Object and Space Perception Battery (VOSP) Wechsler Abbreviated Scale of Intelligence (WASI) Wechsler Adult Intelligence Scales - (WAIS) Wechsler Individual Achievement Test – (WIAT) Wechsler Intelligence Scales for Children – (WISC) Wechsler Test of Adult Reading (WTAR) Wechsler Memory Scale – (WMS) Wide Range Achievement Test – (WRAT) Wide Range Assessment of Memory and Learning - (WRAML) Wisconsin Card Sorting Test (WCST) – both the PC and manual card versions Word Memory Test (WMT) 26 Other terms to know TERM NOTES Chance (as in how likely an examinee is to choose the correct answer) Reliability (including the different types of reliability) Validity (including the different types of validity) Praxis (including the different types of  praxis) Norms (look at the different norms available and which is best for which population/referr al question) 27 References A. I. (2006). The use, education, training and supervision of neuropsychological test technicians (psychometrists) in clinical practice. Official statement of the National Academy of Neuropsychology. Archives of Clinical Neuropsychology: The Official Journal of the National Academy of Neuropsychologists, 21(8), 837-839. Axelrod, B., Heilbronner, R., Barth, J., Larrabee, G., Faust, D., Pliskin, N., &... Silver, C. (2000). The use of neuropsychology test technicians in clinical practice: official statement of the National Academy of Neuropsychology. Approved 5/15/99. Archives of Clinical Neuropsychology: The Official Journal of the National Academy of Neuropsychologists, 15(5), 381-382. Blumenfeld, H. (2002). Neuroanatomy through clinical cases. Sunderland, MA: Sinuaer Associates, Inc. Festa, J. R., Barr, W. B., & Pliskin, N. (2010). The politics of technicians. The Clinical Neuropsychologist, 24(3), 506-517. Doi: 10.1080/13854040802531463 Filly, C. M. (1999). Behavioral neurology for neurologists (Course 37). 19th NAN conference presentation. FitzGerald, M. J. T., Folan-Curran, J. (2002). Clinical neuroanatomy and related neuroscience. (4th Ed.). Edinburgh, UK: W. B. Saunders. Gertz, S. D. (1996). Liebman’s neuroanatomy made easy and understandable. Gaithersburg, MD: Aspen Publishers, Inc. Kolb, B., Whishaw, I. Q. (2009). Fundamentals of Human Neuropsychology. (6th Ed.). New York, NY: Worth Publishers. Lezak, M. D., Howieson, Loring, D. W. (2004). Neuropsychological assessment. (4th Ed.). New York, NY: Oxford University Press. Midbrain anatomy. (2018). In Encyclopedia Britannica online. Retrieved from https://www.britannica.com/science/midbrain. Puente, A. E., Adams, R., Barr, W. B., Bush, S. S., Ruff, R. M., Barth, J. T., & Tröster, Smith, R. and Schuler, P. (2011). Aphasia: Classification, assessment, TBI & stroke. NAP Annual Conference presentation. Spreen, O., Strauss, E., & Sherman, E. M. (2006). A Compendium of Neuropsychological Tests: Administration, norms, and commentary. New York: Oxford University Press. The use of neuropsychology test technicians in clinical practice. (2000). Archives of Clinical Neuropsychology, 15(5), 381-382. 28