Ch. 9: Intellectual & Neuropsychological Assessment PDF

Ch. 9: INTELLECTUAL AND NEUROPSYCHOLOGICAL ASSESSMENT Measuring cognitive performance has been problems, thinking abstractly, a hallmark of clinical psychology since its comprehending complex ideas, learning origin efficiently, and learning from e...

Ch. 9: INTELLECTUAL AND NEUROPSYCHOLOGICAL ASSESSMENT Measuring cognitive performance has been problems, thinking abstractly, a hallmark of clinical psychology since its comprehending complex ideas, learning origin efficiently, and learning from experience help a clinical psychologist with diagnosis intelligence is the ability to learn, adapt, and treatment and solve problems.} Some assessments, such as those for Charles Spearman: Intelligence Is One specific learning disorder (formerly known Thing as learning disabilities), intellectual disability (also known as intellectual Charles Spearman developmental disorder, and formerly - Intelligence is a singular known as mental retardation), or characteristic giftedness, focus on cognitive issues from - “g” for general intelligence the start - it represented a person’s global, In other assessments, such as those overall intellectual ability. focusing on mood disorders or disruptive - he measured many different, behavior, cognitive tests can provide specific capabilities of his important contextual information. participants, including academic abilities and sensory-discrimination three types of tests tasks - strong correlation between this 1. Intelligence tests - client’s wide range of abilities, suggesting intellectual abilities that a single factor underlies them 2. Achievement tests - measure what all. a client has accomplished with - more specific abilities (“s”) existed, those intellectual abilities but he argued that they played a 3. Neuropsychological tests - issues relatively minor role in intelligence. of cognitive or brain dysfunction, including the effects of brain injuries Louis Thurstone: Intelligence Is Many and illnesses. Things INTELLIGENCE TESTING Louis Thurstone Classic Theories of Intelligence - intelligence should not be understood as a single, unified What is intelligence? ability but as numerous distinct speed of mental processing, abilities that have little relationship sensory capacity, to one another. abstract thinking, - pioneer of the statistical procedure imagination, called multiple factor analysis (o adaptability, identify underlying factors in a large capacity to learn through data set) experience, - he found several independent memory, factors. reasoning, and verbal comprehension, inhibition of instinct numerical ability, spatial reasoning, and {Intelligence is the general mental capacity memory that involves reasoning, planning, solving Ch. 9: INTELLECTUAL AND NEUROPSYCHOLOGICAL ASSESSMENT hierarchical model of intelligence IV Tests of Cognitive Abilities, Kaufman Assessment Battery for - specific abilities (“s”) existed and Children-II were important - but they were all at least somewhat Wechsler Intelligence Tests related to one another and to a - David Wechsler global, overall, general intelligence 1. Wechsler Adult Intelligence Scale— (“g”) Fourth Edition (WAIS-IV) More Contemporary Theories of 2. Wechsler Intelligence Scale for Intelligence Children—Fifth Edition (WISC-V) 3. Wechsler Preschool and Primary James Cattell Scale of Intelligence—Fourth - proposed two separate Edition (WPPSI-IV) intelligences - cover virtually the entire life span 1. fluid intelligence - ability to - indeed separate tests rather than reason when faced with slight variants of one another novel problems similarities: 2. crystallized intelligence - body of knowledge one has - They yield a single full-scale accumulated as a result of intelligence score life experiences. - four or five index scores - a dozen specific subtest scores John Carroll - employ a hierarchical model of - three-stratum theory of intelligence ( full-scale intelligence intelligence score reflects a general, global level - intelligence operates at three levels of intelligence (“g”) and the 1. a single “g” at the top index/factor scores and subtest 2. eight broad factors immediately scores represent increasingly beneath “g” specific areas of ability (“s”)) 3. more than 60 highly specific - They are administered one-on-one abilities beneath these broad and face-to-face factors. - Wechsler tests cannot be administered to a group of examinees at the same time, nor are - most contemporary intelligence they entirely pencil-and-paper tests tests mirror this view by producing a - structured interpersonal interaction single overall score (one number to requiring extensive training, represent how intelligent a person typically received during graduate is) programs in clinical psychology - in addition to a number of other - Each subtest is brief (lasting about scores representing more specific 2–10 minutes) and consists of items abilities that increase in difficulty as the - ex: Wechsler and Stanford-Binet, subtest progresses. Woodcock-Johnson tests, - subtests are designed such that Woodcock-Johnson IV Tests of Early examinees continue until they fail a Cognitive and Academic predetermined number of Development, Woodcock-Johnson consecutive items (or “max out,” to state it informally). Ch. 9: INTELLECTUAL AND NEUROPSYCHOLOGICAL ASSESSMENT 4. Processing Speed Index—a measure of the ability to process simple or rote information rapidly and accurately - They feature large, carefully collected sets of normative data - So when an examinee takes a Wechsler intelligence test, the examinee’s performance is compared with the performance of a large, same-age sample of individuals representing a wide- scale national population. - The full-scale and index scores generated by the Wechsler tests are “IQ” scores, meaning that they - most subtests appear in all three reflect an intelligence “quotient.” tests as either core or supplemental - ” This quotient is the result of a subtests. division problem in which the - Originally, the Wechsler tests were examinees’ raw scores are designed with two categories of compared with age-based subtests: expectations. 1. verbal and - mean IQ scores (full-scale and 2. performance index) are 100 - they cluster together in four or five, - sd of 15 rather than two, factors - subtest, a score of 10 is average - the WAIS has four factors - sd of 3 - WISC and WPPSI each have five - The Wechsler intelligence tests factors (essentially, they share share a general approach to three with the WAIS, but the interpretation of scores Perceptual Reasoning Index of the - Assessors are instructed to first WAIS is divided into Visual Spatial consider the full-scale IQ score. Index and Fluid Reasoning Index) - they move on to interpret each index 1. Verbal Comprehension score in relation to the others and Index—a measure of verbal then the pattern of subtest scores. concept formation and - observable patterns of behavior verbal reasoning - backed by very impressive 2. Perceptual Reasoning psychometric data. Index—a measure of fluid - strong reliability and validity reasoning, spatial - used for a wide range of clinical processing, and visual- applications motor integration 1. evaluations that focus on 3. Working Memory Index—a issues of intellectual measure of the capacity to disability, store, transform, and recall 2. developmental delays, incoming information and giftedness, data in short-term memory Ch. 9: INTELLECTUAL AND NEUROPSYCHOLOGICAL ASSESSMENT 3. educational and vocational - Rather than three separate tests planning, for three different age ranges, 4. school placement and the SB5 covers the entire life qualification, span (ages 2–85+) as a single 5. and other targeted test assessment questions - includes normative data from - used to provide general intelligence individuals with specific information relevant diagnoses, including - including a comprehensive learning problems, intellectual assessment of a client whose disability presenting problems are more - very easy and very difficult neuropsychological, emotional, or items—as an effort to more behavioral accurately assess people at the - first to become available on a digital extremes, including those who platform (Q-interactive system) may have intellectual disability - subtests may be culturally loaded or be gifted or biased, the connection between - Wechsler tests feature four or the tests and day-to-day life five factors, each of which yields (ecological validity) may be limited, an index score, the SB5 features and scoring can be complex or exactly five, described briefly subjective on some subtests here: 1. Fluid Reasoning—the ability to Stanford-Binet Intelligence Scales— solve novel problems Fifth Edition 2. Knowledge—general information Stanford-Binet intelligence tests accumulated over time via personal experiences, including education, - highly respected and offers an home, and environment approach to assessing 3. Quantitative Reasoning—the intelligence that is both similar ability to solve numerical problems to and different from that of the 4. Visual-Spatial Processing—the Wechsler tests ability to analyze visually presented Stanford-Binet Intelligence Scales—Fifth information, including relationships Edition (SB5) between objects, spatial orientation, assembling pieces to - most recent revision make a whole, and detecting visual - administered face-to-face and patterns one-on-one. 5. Working Memory—the ability to - hierarchical model of hold and transform information in intelligence short-term memory - e yields a singular measure of full-scale IQ (or “g”), five factor - Each of these five factors is scores, and many more specific measured both verbally and subtest scores nonverbally - same means (100); standard - assessed by one to three specific deviations (15) types of items - reliability and validity, are - Overall, current editions of the similarly strong. Wechsler tests may have become more widely used than the current Ch. 9: INTELLECTUAL AND NEUROPSYCHOLOGICAL ASSESSMENT edition of the Stanford-Binet, but the objects from the first the SB5 continues to hold a similar array position of respect and, in some 2. Spatial Memory - recalls settings, popularity as it has for the the placement of colored past century chips on a three-by-three or four-by-four grid Additional Tests of Intelligence: 3. Symbolic Memory - recalls Addressing Cultural Fairness and re-creates sequences of Cultural fairness visually presented symbols - featuring numerous subtests Three subtests (Reasoning) - verbal skills 1. Cube Design - arranges - intelligence test is based on culture- colored blocks in a specific specific concepts, it may unfairly threedimensional design assess the intelligence of people of 2. Mazes - examinee other cultures completes traditional maze Universal Nonverbal Intelligence Test-2 puzzles 3. Analogic Reasoning - - published in 1996 examinee solves analogy - revised in 2015 problems that are presented - completely language-free test of visually rather than verbally intelligence - assesses a more limited range of - no speaking or shared abilities than more traditional IQ understanding of language between tests the person administering the test - only for young clients and the person taking it - limited in quantity - administered one-on-one and face- - unfamiliar to many clinical to-face psychologists - eight specific hand gestures - demonstrated in an accompanying Wechsler Nonverbal Scale of Ability video - only minimal spoken instructions - responses of the examinee pointing - mostly pictorial directions with fingers or minor manipulation of objects with hands or fingers ACHIEVEMENT TESTING - aged 5 to 21 Achievement Versus Intelligence - normed on 1,800 people - generally acceptable reliability and - intelligence - person’s cognitive validity capacity - two-tiered model of intelligence - what a person can 1. Memory accomplish intellectually 2. Reasoning - achievement - what a person has accomplished Three subtests (Memory) - learn in school, such 1. Object Memory - views a as reading, spelling, writing, or visual assortment of math. common objects for 5 - Achievement tests typically seconds and then views a produce age- or grade-equivalency larger array and identifies scores as well as standard scores Ch. 9: INTELLECTUAL AND NEUROPSYCHOLOGICAL ASSESSMENT - In DSM-5, the terminology changed statistics and probability questions, (“learning disability” is now called etc.) specific learning disorder) 3. Written Language Composite - person’s achievement (as - Spelling (increasingly difficult measured by achievement tests and words) performance at school or work - Sentence Composition - expected levels of achievement for - Essay Composition (constructing people of the same age sentences, paragraphs, or essays - typically explain their findings in a as instructed written psychological report 4. Oral Language Composite - Some measure a single area of - Listening Comprehension (paying achievement in detail, such as the attention to orally presented KeyMath or the Gray Oral Reading information and answering achievement tests questions about it - Others are more comprehensive - Oral Expression (using speech to (the Woodcock-Johnson Tests of repeat spoken material, create Achievement (WJ-ACH), the stories about presented pictures, Kaufman Test of Educational provide directions, etc.). Achievement (KTEA), and the Wechsler Individual Achievement Test (WIAT)) NEUROPSYCHOLOGICAL TESTING Wechsler Individual Achievement Test— - specialized area of assessment Third Edition (WIAT-III) within clinical psychology - clinical psychologists with extra - comprehensive achievement test training in neuropsychology for clients aged 4 to 50 years. - measure cognitive functioning or - face-to-face and one-on-one impairment of the brain and its - measures achievement in four specific components or structures broad areas: reading, math, written - Medical procedures such as language, and oral language (two to computed tomography (CT), four subtests) magnetic resonance imaging (MRI), and positron emission tomography 1. Reading Composite (PET) scans can show that parts of - Word Reading (reading isolated the brain look abnormal, but words) neuropsychological tests can - Pseudoword Decoding (using indicate how the brain is actually phonetic skills to sound out functioning. nonsense words, such as plore or - used to make a prognosis for tharch improvement, plan rehabilitation, - Reading Comprehension (reading determine eligibility for sentences or passages and accommodations at school or work, answering questions about their and establish a baseline of content neuropsychological abilities to be 2. Mathematics Composite used as a comparison at a later time - Numerical Operations (written math - neuropsychological testing problems) procedures are lengthy, - Math Problem Solving (word problems, numerical patterns, Ch. 9: INTELLECTUAL AND NEUROPSYCHOLOGICAL ASSESSMENT - comprehensive batteries that 1. Trail Making Test - “dot-to-dot” include a broad array of subtests puzzles, timed, contains both - used as screens for numbers and letters, and produces neuropsychological impairment a rather haphazard line instead of rather than as full-fledged an identifiable figure or shape neuropsychological assessment 2. Category Test - client sees a tools. pattern of shapes and designs on a - field has evolved from a “fixed- screen and presses the number key battery phase” in which (1–4) that is suggested by the psychologists typically use the pattern. a bell when correct and a same standard set of tests for most buzzer when wrong. clients to a more “flexible-battery 3. Finger Tapping (or Finger phase” in which psychologists Oscillation) Test - tap a single create a more customized battery typewriter key, for 10-second by picking and choosing tests after intervals. The number of taps they considering the specific referral can produce, averaged across questions and areas of concern multiple attempts with each hand, neuropsychological assessment estimates motor speed anxiety - experience in which Luria-Nebraska Neuropsychological clients’ performance on these tests Battery (LNNB) is influenced by the anxiety in the moment. - wide-ranging test of neuropsychological functioning Full Neuropsychological Batteries - 12 scales Halstead-Reitan Neuropsychological - emphasis on qualitative data in Battery (HRB) addition to quantitative data. - qualitative written comments from - battery of eight standardized the examiner about the testing neuropsychological tests. process - 15 years and older - examiner observed - alternate versions are available for - problems comprehending the test younger clients. - how or why the client is missing - administered only as a whole items battery; its components are not to - or unusual behaviors be administered separately - slightly briefer - identify people with brain damage, - strong body of psychometric data brain damage identified, specific supports the LNNB’s reliability and cognitive impairments or validity physiological regions of the brain that may be deficient, diagnosis and NEPSY-II treatment - neuropsychological tests designed eight tests in the HRB specifically for children. - 3 and 16 years 1. sight - 32 separate subtests 2. hearing - 6 different categories: attention and 3. touch executive functioning, language, 4. motor skills memory and learning, 5. and pencil-and-paper tasks Ch. 9: INTELLECTUAL AND NEUROPSYCHOLOGICAL ASSESSMENT sensorimotor, social perception, Repeatable Battery for the Assessment of and visuospatial processing. Neuropsychological Status (RBANS) Brief Neuropsychological Measures - neuropsychological screen that focuses on a broader range of Bender Visual-Motor Gestalt Test— abilities than does either the Second Edition Bender-Gestalt or the Rey- - most commonly used Osterrieth. neuropsychological screen among - visuomotor abilities clinical psychologists - verbal skills, attention, and visual - a straightforward copying task: The memory client is given a pencil, blank paper, - 20 to 30 minutes and nine simple geometric designs, - 12 subtests in 5 categories: asked to copy each design. - immediate and delayed memory, - visuoconstructive abilities, visuospatial/constructional, perceptual-motor or visual-spatial language, attention, and delayed skills, memory tasks and additional memory stimuli - learning a list of 10 words presented - 6 minutes to administer orally, naming pictures of various - above 3 years objects, recalling an orally - a quick “check” for presented list of numbers, recalling neuropsychological problems. a story told 20 minutes earlier, - clinical psychologist simply wants a copying of visual figures rapid appraisal of overall - total score as well as scores for neuropsychological functioning each of the 12 subtests and 5 - cannot specify locations, poor indices into which they are performance, can suggest brain organized damage - RBANS Update 2012 and enables - missing or notably inexact; figures the test to be administered to that collide with each other on the children as young as 12 years old page; inability to accurately “close” Wechsler Memory Scale—Fourth Edition shapes such as circles or squares; disproportionate size of a figure or - frequently utilized for part of a figure; and angles in copied neuropsychological purposes. figures that do not match the angles - memory test, assess individuals in the originals aged 16 to 90 who are suspected of having memory problems due to Rey Osterrieth Complex Figure Test brain injury, dementia, substance - 1941 abuse, or other factors - pencil-and-paper drawing task - visual and auditory memory across - single, more complex figure. its seven subtests - different colors at various points in - both immediate and delayed recall the test - Logical Memory - client hearing a - client’s sequential approach story read aloud and then trying to - memory component recall the story both immediately and after a 20- to 30-minute delay. - Visual Reproduction - presenting abstract visual figures to the client Ch. 9: INTELLECTUAL AND NEUROPSYCHOLOGICAL ASSESSMENT and asking him or her to reproduce them after they have been removed. - 65 years of age, version that is shorter in duration, therefore minimizing the impact of fatigue on test results - cultural competence, when selecting, administering, scoring, and interpreting neuropsychological tests were standardized on European Americans. - it is important to caution against overpathologizing and to consider (or consider developing) culture- specific norms whenever possible