10/24 Cognitive Assessment - Dobkin Flashcards
IQ testing controversy
1. nature vs nurture : heredity may set the range → environment does the rest
2. stability : IQ scores fairly stable with mild increases over time!
- do see age-related decline
3. predictability
- good predictor of short-term academic ability
- weak relationship to occupational status, job performance, creativity, attainment in life
IQ testing
what is IQ
2 tests
pros vs cons
“intelligence quotient” : estimate of current level of fx as measured by tasks required by the test
- Wechsler Adult Intelligence Scales (WAIS IV) - age 16-69
- Wechsler Intelligence Scales for Children (WISC IV) - age 6-16
pros:
- fairly accurate predictor of short-term academic prediction
- good info re: cognitive strengths and weaknesses
- can aid with ddx
- can reveal imp personality variables
- useful for tracking one person over time
cons:
- labeling/stereotyped categories
- cultural and/or gender bias
- misuse of scores
- ltd predictability in non-academic arenas (but often used for this purpose)
- ltd sample
- outcome-oriented (vs process-oriented)
WAIS IV
waht does it measure
how do we interpret the score
measures global ability
conceptualized 4 ways:
- full scale IQ (mean = 100, SD 15)
- four index scores
- General Ability Index
- verbal comprehension: vocab, info, similarities
- perceptual reasoning: block design, matrix reasoning, visual puzzles
- working memory: digit span, arithmetic
- processing speed: symbol search, coding
- subtest scores
10 core subjects
achievement vs aptitude tests
achievement : assess what has been learned in past
aptitude : predictor of future behavior
- distinction between two tests may be artificial → innate ability and environment account for similar variability in both types of tests
common achievement tests
WRAT-4 : Wide-Range Achievement Test
- assessment of grade level fx in Reading, Spelling, Arithmetic
WIAT : Wechsler Individual Achievement Test
- maps onto Wechsler IQ scales (scores can be directly predicted from IQ)
neuropsychological testing
goals
- screen for, diagnose, track neurological disorders
- determine if a problem behavior is organic or functional
- inform tx planning
- evaluate a variety of cognitive fx
issues in neuropsych testing
balancing false negative and false positives
- narrowness vs width of test: testing enough (to catch issues) but not too much (such that you’re guaranteed to catch an issue)
pathognomic vs quantitative cutoff scores
consider moderators (age, ed, ethnicity, phys disability)
predict with caution
selecting a type of battery (fixed vs flexible)
types of neuropsychological batteries
- fixed
- strengths and weaknesses broadly assessed
- good for research/training
- time-consuming, hard to tailor to referral
- outcome-focused
- flexible
- easily tailored to client and referal question
- process-emphasized, time-efficient
- decided based on clinician judgment
- harder to apply to research/training
- mixed
* jshort fixed or core battery PLUS flexible tests based on unique client and specifics of referral
assessment of attention
frontal lobes
- can be affected by variety of disorders (ADHD, depression, dementia)
tests:
- trail making test
- digit span
- arithmetic
- stroop
assessment of language
frontal and temporal lobes
- affected: speech, repetition, comprehension, naming, reading, writing
- APHASIAS are the most common
- Broca’s : speech production (frontal)
- Wernicke’s : comprehension (temporal)
assessment of visuo-spatial domain
parietal and occipital lobe
- problems: visual neglect, disturbance in L/R or topographic orientation, difficulty with visual org and constructional ability, visual agnosia, simultanagnosia, prosopagnosia
- tests:
- block design
- object assembly
- etc
assessment of memory
temporal and frontal lobes, hippocampus
- affected by: Alz, dementia, depression, normal aging!
- difficulties influenced by time of initial exposure, modality of presentation, locus of reference
executive fx
ability to produce cognitions and behavior in a planned, organized, responsive manner
frontal lobe
affected by: alcoholism, depression, autism, ADHD, schizophrenia, malingering, PD
test for:
- planfulness vs impulsivity
- abstract vs concrete thinking
- initiation vs abulia
- self-awareness vs obliviousness
- flexibility vs perseveration
