2- Neuropsychological Evaluation Flashcards
Three key ideas about neuropsychological evaluation covered by this lecture
C_____ f_______
B_____ a______
T________
Cognitive functions
Brain areas
Testing
What tools are used to complete behavioural assessments?
Standardised tests sensitive to brain-behaviour relationships
Testing is _______ and can focus on intelligence, problem solving, attention, memory and language, perceptual and motor abilities, emotions and personality
Multidimensional
When is a neuropsychological evaluation recommended?
When a brain-based impairment is suspected
Where do referrals for neuropsychological evaluations originate? Name 4
GP
Neurologist
Lawyer
Workplace
We are looking at 5 possible purposes for evaluation. This one is about brain-based vs not brain-based impairments
Differentiating organic (brain level) and functional (not brain level) impairments
What is an organic impairment?
What is it compared to?
One at the brain level.
Compared to a functional impairment which is not brain level.
We are looking at 5 main purposes for evaluations. This one is about creating a profile.
Profile of strengths and weaknesses.
A purpose of evaluation is to create a profile of 1. ___ and 2 _____.
- Is to:
- Is to:
Strengths
Weaknesses
1. Strengths - use to work around deficits
2. Weaknesses - target areas of rehab
We are looking at 5 main purposes of evaluations. This one is about keeping track.
Monitor rehab progress
We are looking at 5 main purposes of evaluations. This one is about the law.
Disability determination for forensic / legal purposes. Medicolegal.
We are looking at 5 main purposes of evaluation. This one is about the person’s day to day._____
Three examples are:
Determining the impact on a patient’s life.
For example: driving, work, social life
Neuropsychological evaluations take an integral approach which can also incorporate these three factors:
______ eg personal, family history
_______ eg cranial nerve function, muscle tone
_______ eg CT, PET
Background
Neurologic examination
Neuroimaging data
There are 4 psychometric issues that need to be considered.
One is about testing everyone in the same conditions
Standardisation
There are 4 psychometric issues that need to be considered. One is about comparing patients against the average results
Test norms
There are 4 psychometric issues that need to be considered. One is about getting the same result each time, across time.
Reliability
There are 4 psychometric issues that need to be considered. One is about getting an accurate result, or testing what needs to be tested.
This can be broken into three areas.
___ ____ is about testing the actual issue
___ ____ is about making sure present tests test the same thing as previous ones, with new technology etc
___ ___ is about being able to presume future outcomes
Validity
Construct validity
Concurrent validity
Predictive validity
Neuropsychological testing is multidimensional. There is a battery of tests that are used. These tests focus on 8 functional areas. Name 3.
Are the answers listed from basic to complex or complex to basic?
Orientation Sensation and perception Attention Motor skills Language Visual-spatial organisation Memory Executive function
Basic to complex
(Lower/higher) complexity functions can be mapped easily onto brain areas, whereas (lower/higher) complexity functions use a range of areas
Lower
Higher
Of the 8 functional areas that can be tested, this one is about the awareness of self to the world. \_\_\_\_\_\_ This comes in 3 ways : \_\_\_\_ (ie I am Fleur) \_\_\_\_ (ie the date is) \_\_\_\_ (ie I am on campus)
Orientation
Person
Time
Place
Of the 8 functional areas that can be tested, this one is about the awareness of self to the world.
______
The cortical location is the _____ ______
Orientation
Reticular formation
Of the 8 functional areas that can be tested, this one is about the awareness of self to the world. _______
This is tested using the _______ (and abbreviation). This test has 8 questions.
Orientation
Galveston Orientation and Amnesia Test
Of the 8 functional areas that can be tested, this one is about stimulation of sensory organs, and making sense of this (processing, interpretation)
Sensation and perception
Vision comes under the functional area of:____ _____
The primary brain area for experiencing vision in a simple way, including seeing light and shape, without meaning, is in the _____ lobe. This is at the _____ of the head.
Sensation and perception
Occipital
Back
Vision comes under the functional area of ____
The secondary areas for experiencing vision include processing.
______ is in the temporal lobe
______ is in the parietal lobe
Sensation and perception
Object recognition
Location
Hearing comes under the functional area of ________.
The primary area for experiencing hearing is in the ______ lobe. This includes basic sound elements such as: (list 2 things)
Sensation and perception
Temporal
Loudness, duration
Hearing comes under the functional area of ________.
Secondary areas for processing hearing include ______ area, which is in the temporal lobe. This area involves processing spoken information - understanding language.
Sensation and perception
Wernicke’s
Hearing comes under the functional area of ________.
Secondary areas for hearing include ______ area, which is in the frontal lobe. This area involves expressive language and producing speech.
Sensation and perception
Broca’s
Sensation and perception is conceptually the _______ system. It is organised _____, which means the right brain deals with the left hand, etc.
Somatosensory
Contralaterally
Testing sensation and perception includes subtests of the Halstead-Reiten Neuropsychological _____ (HRNB), in visual, auditory and tactile modalities.
Battery
The third of the 8 functional areas is _____. This includes concentrating over a long period, which is called _______, and focusing on more than one thing at once, which is called ______.
Attention
Sustained
Selective
______ is a functional area tested using the Symbol Digit Modalities Test, and the D2 Test of Attention.
Attention
This is the 4th of the 8 functional areas, which involves demonstrating movement and control in the upper and lower extremities.
The primary and secondary cortal areas are in the _____ lobes - these are about sequencing movement and planning movement.
Motor skills
Frontal
Testing _____ includes subtests of the HRNB (Halstead-Reiten Neuropsychological Battery). This includes the finger tapping test and the grip strength rest.
Motor skills
The fifth of the 8 functional areas is ______, which involves verbal communication skills.
These include receptive or understanding skills, which is in ______ area in the temporal lobe, and expressive skills, which is in ____ area in the frontal lobe.
Language
Wernicke’s
Broca’s
This functional area is tested using the Token test, the Controlled Oral Word Association Test (COWAT), and the Boston Naming Test
Language
