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Neuropsychological
Assessment
By: Tiffany Gail C. Clamucha
Definition of Terms
Neuropsychology
A branch of Psychology that focuses on the relationship between brain functioning and
behavior.
Neuropsychological Assessment
Evaluation of brain and nervous system functioning as it relates to behavior.
General Elements of
a Neuropsychological
Evaluation
• Objectives:
1. Draw inferences about the
structural and functional
characteristics of a person’s brain.
2. Evaluate an individual’s behavior in
defined stimulus-response
situations.
Factors to be considered:
Nature of the
referral question
Capabilities of the
client
Availability and
nature of records
regarding the
client
Practical
considerations
(time, location,
etc.)
Common to all thorough neuropsychological
examinations are:
Relevant records
Careful history taking
Presence or absence of certain developmental milestones
Mental Status Examination.
Psychosocial history
Tests administered should focus on the following
domains:
Mental Activity
Visuoconstructive
Abilities
Memory and
learning
Verbal functions
including academic
skills
Executive
functions
Motor performance Emotional status
General strategies in neuropsychological
assessment
QUALITATIVE SIGN
APPROACH
QUANTITATIVE
CUTOFF SCORES
Neuropsychological Tests
Tests of General Intellectual Ability
Tests to measure the Ability to Abstract
Tests of Executive Function
Tests of Perceptual, Motor, and Perceptual Motor Function
Tests of Verbal Functioning
Tests of Memory
Tests of General
Intellectual Ability
Wechsler
Tests
Tests to Measure the Ability to Abstract
Verbal Abstraction Ability
a. Wechsler Similarities Subset
• Identify how two objects are alike
b. Proverbs Test
• “A stitch in time saves nine.”
Tests to
Measure the
Ability to
Abstract
1. Non-verbal Abstraction
Ability
a. Object Sorting Test
a. Color-Form Sorting Test
Tests of
Executive
Function
Tower of Hanoi
Bender-Gestalt Visual
Motor Test
• Developed by a child
psychiatrist named Lauretta
Bender
• First published in 1983
Tests of Perceptual, Motor,
and Perceptual-Motor
Function
Bender-Gestalt Visual Motor Test
Screening device for
neuropsychological
impairment by
assessing client’s
visuoconstructive
abilities.
9 designs sequentially
presented to the test
taker with instructions to
reproduce them.
Rated based on their
relative degree of
accuracy and overall
integration.
The Bender
• A recall phase was added
• “Now please draw all of the designs
you can remember”
• Subjects diagnosed as neurotic
would be able to recall fewer figures
on the recall portion of the test than
would normal subjects
Tests of
Verbal
Functioning
• Controlled Word Association Test
The examiner says a letter of the alphabet and
then it is the subject’s task to say as many words
as he or she can think of that begin with that letter.
Tests of Memory
CALIFORNIA VERBAL
LEARNING TEST-II
WECHSLER MEMORY
SCALE IV
Challenges
1. Merging test
interpretation with
multiple sources of
information
2. Developing effective
intervention
3. Having a sound
understanding of the
brain-behavior
relationship
4. Knowing the
strengths and
limitations of each test
Challenges
Integrating aspects of the individual’s inherent features
and environmental contributions
Integrating
Translating information into meaningful recommendations
Translating
Communicating report to the person/family in
understandable terms.
Communicating
A Neuropsychological Evaluation Can:
provide evidence that a
brain injury has caused
changes
give an idea of
what the person
can or cannot be
expected to do
help identify what a
person needs to be
successful, including
adaptations and
compensation strategies,
supervision, learning
style, or teaching
strategies
help people understand
how the injury has
changed them
help others see how
people with the brain injury
see themselves
help plan
rehabilitation or
other treatment
aid in
educational
planning
aid in
vocational
planning
document
changes for
legal purposes
Thank you 

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Neuropsycological Assessment psychology

  • 2. Definition of Terms Neuropsychology A branch of Psychology that focuses on the relationship between brain functioning and behavior. Neuropsychological Assessment Evaluation of brain and nervous system functioning as it relates to behavior.
  • 3. General Elements of a Neuropsychological Evaluation • Objectives: 1. Draw inferences about the structural and functional characteristics of a person’s brain. 2. Evaluate an individual’s behavior in defined stimulus-response situations.
  • 4. Factors to be considered: Nature of the referral question Capabilities of the client Availability and nature of records regarding the client Practical considerations (time, location, etc.)
  • 5. Common to all thorough neuropsychological examinations are: Relevant records Careful history taking Presence or absence of certain developmental milestones Mental Status Examination. Psychosocial history
  • 6. Tests administered should focus on the following domains: Mental Activity Visuoconstructive Abilities Memory and learning Verbal functions including academic skills Executive functions Motor performance Emotional status
  • 7. General strategies in neuropsychological assessment QUALITATIVE SIGN APPROACH QUANTITATIVE CUTOFF SCORES
  • 8. Neuropsychological Tests Tests of General Intellectual Ability Tests to measure the Ability to Abstract Tests of Executive Function Tests of Perceptual, Motor, and Perceptual Motor Function Tests of Verbal Functioning Tests of Memory
  • 9. Tests of General Intellectual Ability Wechsler Tests
  • 10. Tests to Measure the Ability to Abstract Verbal Abstraction Ability a. Wechsler Similarities Subset • Identify how two objects are alike b. Proverbs Test • “A stitch in time saves nine.”
  • 11. Tests to Measure the Ability to Abstract 1. Non-verbal Abstraction Ability a. Object Sorting Test a. Color-Form Sorting Test
  • 13. Bender-Gestalt Visual Motor Test • Developed by a child psychiatrist named Lauretta Bender • First published in 1983 Tests of Perceptual, Motor, and Perceptual-Motor Function
  • 14. Bender-Gestalt Visual Motor Test Screening device for neuropsychological impairment by assessing client’s visuoconstructive abilities. 9 designs sequentially presented to the test taker with instructions to reproduce them. Rated based on their relative degree of accuracy and overall integration.
  • 15.
  • 16.
  • 17. The Bender • A recall phase was added • “Now please draw all of the designs you can remember” • Subjects diagnosed as neurotic would be able to recall fewer figures on the recall portion of the test than would normal subjects
  • 18.
  • 19. Tests of Verbal Functioning • Controlled Word Association Test The examiner says a letter of the alphabet and then it is the subject’s task to say as many words as he or she can think of that begin with that letter.
  • 20. Tests of Memory CALIFORNIA VERBAL LEARNING TEST-II WECHSLER MEMORY SCALE IV
  • 21. Challenges 1. Merging test interpretation with multiple sources of information 2. Developing effective intervention 3. Having a sound understanding of the brain-behavior relationship 4. Knowing the strengths and limitations of each test
  • 22. Challenges Integrating aspects of the individual’s inherent features and environmental contributions Integrating Translating information into meaningful recommendations Translating Communicating report to the person/family in understandable terms. Communicating
  • 23. A Neuropsychological Evaluation Can: provide evidence that a brain injury has caused changes give an idea of what the person can or cannot be expected to do help identify what a person needs to be successful, including adaptations and compensation strategies, supervision, learning style, or teaching strategies help people understand how the injury has changed them help others see how people with the brain injury see themselves help plan rehabilitation or other treatment aid in educational planning aid in vocational planning document changes for legal purposes

Editor's Notes

  1. The objective of the typical neuropsychological evaluation is “to draw inferences about the structural and functional characteristics of a person’s brain by evaluating an individual’s behavior in defined stimulus-response situations”
  2. Exactly how the neuropsychological examination is conducted will vary as a function of a number of factors such as the nature of the referral question, the capabilities of the client, the availability and nature of records regarding the client, and practical considerations (such as the time available to conduct the examination).
  3. 1. The examination of a patient typically begins with a thorough examination of available, relevant records, such as the medical, educational, family reports, employer reports, prior neuropsychological evaluation records. 2. Next is careful history taking, such as interviewing the client himself, his immediate family, and other relatives. 3. Third is evaluating if there is a presence or absence of certain developmental milestones. 4. Fourth is the administration of tests including Mental Status Examination. 5. And lastly is the Examination of Psychosocial history of the client, such as the level of academic achievement, estimated level of intelligence, and level of adjustment at home, work, or school.
  4. Neurological tests should focus on the following domains Mental Activity or anything that stimulates, activates or enriches the mind.. Visuoconstructive Abilities, which involve the coordination of fine motor skills with spatial abilities, usually in the reproduction of geometric figures. 3. Memory and learning 4. Verbal functions including academic skills 5. Executive functions, such as planning and organizing 6. Motor Performance, such as the fine and gross motor coordination. 7. Emotional Status, which includes enjoyment, sadness, fear, anger, and disgust
  5. There are two general strategies in neuropsychological assessment: Qualitative Sign Approach, which assumes the existence of distinctive behaviors indicative of brain damage. Quantitative Cutoff Scores, which optimally separates a person’s performance into either a brain-damage or normal range.
  6. Tests of intellectual ability, particularly Wechsler tests, occupy a prominent position among the diagnostic tools available to the neuropsychologist. The varied nature of the tasks on the Wechsler scales and the wide variety of responses required make these tests potentially very useful tools for neuropsychological screening. For example, a clue to the existence of a deficit might be brought to light by difficulties in concentration during one of the subtests.
  7. 1. One traditional measure of verbal abstraction ability has been the Wechsler Similarities subtest, isolated from the age-appropriate version of the Wechsler intelligence scale. The task in this subtest is to identify how two objects (for instance, a ball and an orange) are alike. 2. Another type of task used to assess ability to think abstractly is proverb interpretation. If your interpretation of this proverb conveyed the idea that haste makes waste, then you have evinced an ability to think abstractly. By contrast, some people with neurological deficits might have interpreted that proverb more concretely. When sewing, take one stitch at a time—it’ll save you from having to do it over nine times. This type of response might betray a deficit in abstraction ability.
  8. Nonverbal tests of abstraction include any of the various tests that require the respondent to sort objects in some logical way. Representative of such tests are the Object Sorting Test and the Color-Form Sorting Test, which require test takers to sort objects of different shapes and colors.
  9. Sorting tests measure one element of executive function, which may be defined as organizing, planning, cognitive flexibility, and inhibition of impulses and related activities associated with the frontal and prefrontal lobes of the brain. One test used to measure executive function is the Tower of Hanoi. It is set up by stacking the rings on one of the pegs, beginning with the largest-diameter ring, with no succeeding ring resting on a smaller one.
  10. Perhaps one of the most widely used neuropsychological instruments is the Bender Visual-Motor Gestalt Test, usually referred to simply as the Bender-Gestalt, or even just “the Bender” The Bender was developed by Lauretta Bender and it was first published in 1983.
  11. Soon, a number of modifications to the administration procedure were proposed. One such modification was the addition of a recall phase. After all nine designs had been copied, a blank piece of paper was placed before the testtaker with the instructions “Now please draw all of the designs you can remember.” Owing to the pressure of the unexpected second test, subjects diagnosed as neurotic would be able to recall fewer figures on the recall portion of the test than would normal subjects.
  12. Verbal fluency and fluency in writing are sometimes affected by injury to the brain, and there are tests to assess the extent of the deficit in such skills. In the Controlled Word Association Test, the examiner says a letter of the alphabet and then it is the subject’s task to say as many words as he or she can think of that begin with that letter.
  13. A widely used test of memory is the California Verbal Learning Test–II. The task is to repeat a list of words that are read by the examiner. Designed for use with test takers from ages 16 to 90, the WMS provides index scores for Auditory Memory, Visual Memory, Visual Working Memory, Immediate Memory, and Delayed Memory