Assessment L5 - WAIS-IV Flashcards

1
Q

What are the goals for the revision of the WAIS-IV?

A

-􏰁Preserve the history of the scales
-􏰁Update the norms/Flynn effect 􏰁
-Update theoretical foundations 􏰁
-Enhance clinical utility
􏰁-Improve psychometric properties 􏰁Increase user-friendliness
􏰁-Increase developmental appropriateness

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2
Q

What is the ‘reliable change’ index?

A

Predicts the nature of improvement as a consequence of practice effects.
–> so you can measure/ test for the degree of which someone performs above the expected improvement.

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3
Q

what was the WAIS-IV Normative Sample?

A

􏰂- Ages- 16-90

  • 􏰂 Normative sample: N = 2200
  • 􏰂 200 examinees per age band for ages 16-69 􏰂
  • 100 examinees per age band for ages 70-90 􏰂
  • National sample stratified by: Sex, Education Level,􏰁 Ethnicity, Region
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4
Q

What are clinical validation studies?

A

These studies validate that the WAIS is doing what we’d want an IQ test to do - EG. diagnosing intellectual disability and giftedness.

  • Making sure that items at the bottom and top of the scale are working just as well.

WAIS is not a tool for diagnosis - it simply shows that clinical conditions affect intellectual functioning.

eg. Depression, dementia, MCI, TBI, ADHD, Intellectual disability, Autism, Learning Disability, Asperger’s.

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5
Q

Why do we use age corrected scores?

A
  • In WAIS-R, the scaled score for each sub test was based on the scores of a non-impaired reference group of examinees, aged 20-34. not good!!
  • age adjusted scaled scores were used for all other ages - but couldn’t be used to determine IQ

Problems:
- Optimal performance does not consistently occur between 20-34
- may lead to interpretive errors - bc score ranges change as participants age
- older people perform worse on processing speed - can’t just standardise on young people bc older people are almost doing 2SD lower, and you’d deem them compromised when they’re intact.
want to compare old people to old people.

  • not possible to use this comparison using the WAIS-III, but with the WAIS-IV this comparison was again possible!! bc WAIS-IV standardises by comparing age with age.
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6
Q

Is education adjusted for in the WAIS-IV

A

No. Only age is adjusted for.

􏰂- Education accounts for 25% of variance in FSIQ scores on WAIS-R (on WAIS-III sub-tests: Information 23.3% through to 0.9% on Symbol Search: i.e. high/verbal low/performance
- Educational adjustment will be important particularly for high functioning/highly educated clients

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7
Q

What is the Flynn Effect?

A
  • Norms in US become out-dated at a rate of 3 IQ points per decade i.e. 1⁄3 to 1⁄2 of a point per year
  • 􏰂Possibly due to: education; nutrition; health; improvement in speed due to computer exposure???

􏰂- Therefore advisable to use newest norms, because they give a more accurate figure

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8
Q

What re the goals in updating the theoretical foundations in WAIS-V??????

A

􏰂 Eliminate dual IQ/index score structure
􏰁- Consistent with WISC-IV
- Consistent measures of WM within the Wechsler memory and intelligence scales - in the WAIS III they were completely different. now the Wais measures verbal WM, and wechsler memory measures visuo-spatial WM

􏰂 Enhance measure of fluid intelligence

  • Develop additional measure of fluid reasoning: Figure Weights
  • they will take on whatever construct and measures they find to measure intellect well.

􏰂 Enhance measure of working memory

  • Revise arithmetic and digit span to emphasise WM
  • arithmetic test is actually a test of WM rather than a test of calculation - because it presents a discursive question which requires a lot of working memory to remember the components - requires a lot of information to be in line to be able to answer the question.

􏰂 Enhance measure of processing speed
- Develop additional PS subtest: Cancellation

􏰂 Enhance theoretical foundations of the scale
- 􏰁 Focus upon CHC theory (but not as much or as closely as Kevin McGrew’s Woodcock Johnston)

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9
Q

What is the cattell-horn-carroll gf-gc Theory?

A
  • WAIS predates CHC
  • Suggests that there are 10 broad abilities that lead to intelligence.
  • 10 broad –> 69 narrow abilities
  • Keith 5 Factors - fluid intelligence, crystiallised intellgence, short term memory, visual processing and processing speed.
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10
Q

What are some factors not well measured by the WAIS-IV - if all all?

A
  • Auditory or spatial memory or new learning 􏰂
  • Creativity
    -􏰂 Daily living skills
    􏰂- Facial recognition/processing
    􏰂- Bodily-kinaesthetic intelligence
    􏰂- Musical intelligence
    􏰂- Planning ability
    􏰂- Practical (inter-personal) intelligence 􏰂
  • Intra-personal intelligence
    􏰂- Receptive vocabulary
    􏰂- Emotional intelligence
    􏰂- Visual closure and gestalt
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11
Q

What is FSIQ and what does it include?

A

Full Scale Intelligence Quotient.

  • Verbal comprehension index
  • Perceptual reasoning index
  • Working Memory Index
  • Processing Speed Index
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12
Q

What are some general assessment considerations?

A
  • NO test exists that measures only a SINGLE construct
  • Measures of GENERAL ABILITY require development of appropriate ITEM-DIFFICULT GRADIENTS:

The degree of construct penetrance varies across the item set –> as you move from low to high questions of the test, should be measuring the same thing the whole way through.

More difficult items will often require multiple cognitive processes

  • 􏰂 Neuropsychological test often have NON NORMAL DISTRIBUTIONS.
    􏰁> Negatively skewed = use percentile ranks.
    􏰁>Affects reliability
    􏰁>Standard scores may be misleading, so percentiles have to be used
  • Memory tests are NOT SOLELY MEMORY TESTS, they
    measure other abilities
    􏰁 >Language
    􏰁 >Visual-perceptual-spatial abilities
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13
Q

What is the difference between index score contributions to FSIW for the WAIS-III and WAIS-IV

A

The constitution of the IQ was changed.

The WAIS-III had uneven spread of things across the set of skills.

WAIS-IV is more evenly spread, VCI=30, PRI=30, WMI=20. PSI=20.

Better because it is more fair - due to people innately being better at different things.

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14
Q

Describe the Frequency distribution of IQ scores

A
􏰂IQ/indices:􏰁 Mean = 100, sd = 15
􏰂
Subtest scaled scores : Mean = 10, sd = 3
􏰂
68% of the population within 1 sd of mean
(i.e. between 85-115 (7-13)
95% within 2 sds [i.e. 70- 130 (4-16)]
􏰂 

Effect sizes are usually as units of sd (thus a large effect size of 0.8 = 0.8 X 15(3)= 12(2.4)&raquo_space;»effect of moderately severe brain damage = 0.5

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15
Q

What does obtaining one or two low scores mean?

A
  • Obtaining one or two low scores on a battery of tests occurs FREQUENTLY in the general population (multivariate vs. univariate base rates)
  • One or two and sometimes more low scores do not necessarily indicate impairment or atypical function

􏰂- We need to consider the level of premorbid functioning of the individual

NEVER base diagnoses on subtests due to individ differences.
Need to have at least 2 impairments then consider premorbid functioning.

NO ONE gets consistently 10’s (mean) across all subtests - variability is intrinsic to the measure

23% of people with 120+ IQ scared 7 or less on one or more subtests, but 2% got one or more low scores on an index!!!

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16
Q

What is considered a low score?

A

-􏰂 An effect size of a .8 is considered large for scaled scores. This translates into clinical means of approximately 7.5 for large effects
􏰂
- Moderate effect sizes are .4 to .8 will scale scores of 7.6 to 8.8

-􏰂 Mild mental retardation adults WAIS-IV subtest scores range from 2.84 digit span to 4.74 visual puzzles - OK if you’re trying to diagnose intellectual disability, but not if you’re trying to diagnose change across time. (use of subtests)
􏰂
- Only most impaired clinical groups fall in the deficient to the borderline range-most are borderline to lower end of average

17
Q

What are the implications of deficit?

A

􏰂 - Hypotheses to be tested will vary by clinical groups, thus ADDITIONAL PROCEDURES may be required to answer the clinical question

**Weschler scales are good bc theyre conormed (between WAIS and weschsler memory scale) and the advanced clinical solutions package - which gives RELIABLE CHANGE INDICES - by looking at premorbid func, education, age, tests of symptom validity etc.

-􏰂 Cognitive deficits are typically NOT UNIQUE to a single clinical group (e.g. processing speed, memory, attention, executive functions deficits are observed in many (maybe all??) clinical groups)

18
Q

What are the methods of testing hypothesis with the WAIS-IV?

A
  • tests can’t diagnose - only clinicians
  • norms and the process approach
  • Kaufman’s approach
  • ## mechanics of test interpretation
19
Q

What is the process approach, using norms?

A

BASICALLY, ADMINISTER THE TEST PROPERLY, IN FULL, USING THE MANUAL, THE WAY IT WAS STANDARDISED.

􏰂- There is no clinical (but maybe an ethical) obligation for any clinician to use norms -

-􏰂 All a test is a structured set of stimuli used for the purposes of eliciting behavioural responses

􏰂- There is no reason that these stimuli cannot be employed as the basis on which explanatory hypotheses regarding process ensue

  • 􏰂 The problem only emerges if you want to use the norms and thus make statements about the performances in the context of the population
  • 􏰂 If you want to use the norms, then you have to use the test in the way that it was originally normed
  • 􏰂 If you do not, then any normative statements regarding the performance are meaningless
20
Q

If you want to use the norms, what should you do

A
  • standard administration
  • conducting an experiment with 1 person every time.
  • adhere precisely to the wording in the manual
  • give appropraite probes as defined in the instructions
  • time each relevant response diligently
  • score each item exactly the way comparable responses were scored during normative procedure

THIS PREVENTS:

  • examiners from applying flexible clinical investigatory procedure during admin
  • from giving feedback to a person who urgently desires it
  • from dislodging from the person’s brain his/her max response for each test.
21
Q

What is Kaufman’s manifesto?

A
  1. “We recommend interpreting test data within the context of a well-validated theory
  2. We recommend using COMPOSITES or CLUSTERS, rather than SUBTESTS, in intra-individual analysis…bc SUBTESTS ARE INTRINSICALLY UNRELIABLE
  3. The clusters that are included in the interpretive analysis should represent BASIC PRIMARY FACTORS in mental organisation (e.g., visual processing, auditory short-term memory)
  4. If a relative weakness revealed through ipsative analysis falls well within the average range of functioning compared to most people, then its meaningfulness is called into question.

> If the subject is performing the way that normal people perform then they probably haven’t got anything wrong - even if they were of higher functioning beforehand.

22
Q

What should diagnostic decisions be based on?

A

Diagnostic decisions should be based on TEST DATA, CLINICAL OBSERVATIONS, BACK GROUND INFO, DATA FROM OTHER ASSESSMENTS, AND REFERRAL QUESTIONS geared specifically to the person being evaluated.

NEVER one of these alone.

23
Q

What is ipsative interpretation?

A

normative = comparing functioning to standardisation sample

ipsative = comparing person’s functioning to themselves across various aspects functioning.
eg. WM performance vs. Visual M performance

24
Q

Why should interpretations be both normative and ipsative?

A

normative = comparing functioning to standardisation sample

Ipsative = comparing person’s functioning to themselves, across various aspects functioning

so you can do both at any one time - gives you the most full set of information.

Interpretation of fluctuations in the persons Index or Factor profile offers the most reliable and meaningful information about WAIS-IV performance because it identifies strong and weak areas of cognitive functioning relative to both same-age peers from the normal population (inter-individual or normative approach) and the person’s own overall ability level (intra- individual or ipsative approach

25
Q

What does Kaufman’s method achieve?

A
  1. Emphasises CLUSER scores and deemphasises individual SUBTEST scores in the interpretive steps
  2. Uses BASE RATE data to evaluate the clinical meaningfulness of clustering index called variability
  3. Grounds interpretation in theories of cognitive abilities (e.g., Cattell-Horn-Carroll’s (CHC) theory and neuropsychological theory), and in the cognitive neuroscience research that forms the theoretical basis for the WAIS-IV
  4. Provides guidance on the use of supplemental measures to test hypotheses about significant subtest variation or outlier scores