Ch. 4

Question 1

Impairment

Answer 1

refer to loss or disorder of cognitive, emotional or physiological function

Question 2

Activity/Functional Limitations

Answer 2

defined as resulting from impairments and refer to effects of impairments on a persons daily life functioning

Question 3

Participation

Answer 3

defined as the nature and extent of a person’s involvement in life situations in relation to impairments, activity limitations, health conditions, and contextual factors.

Question 4

Psychometric Properties: Validity

Answer 4

how accurate the test is

Question 5

Psychometric Properties: Reliability

Answer 5

consistency of a test

Question 6

Psychometric Properties: Generalizability

Answer 6

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Question 7

Noncognitive factors influencing cognitive assessments: Variety of nonspecific factors

Answer 7

➢ Hunger
➢ Fatigue
➢ Headache
➢ Other sources of pain

Question 8

Noncognitive factors influencing cognitive assessments: Some additional physical factors

Answer 8

➢ Visual field deficits
➢ Hemiparesis
➢ Poor visual acuity
➢ Hearing problems

Question 9

Noncognitive factors influencing cognitive assessments: Emotional problems

Answer 9

➢ Anxiety
➢ Worry
➢ Boredom
➢ Preoccupation with other thoughts and concerns

Question 10

Functional Approaches

Answer 10

o Functionally oriented psychometric measures these have been developed by testing people at home, or more natural settings. Also known as, ecologically valid measures.
o Structured observations and functional rating scales
o Direct observations can be extremely useful in functional setting.
o Rating scale can be particularly effective to examine differences in ability across different settings.
o Limitation they may not have adequate psychometric properties.

Question 11

Assessment of Cognitive Abilities: Orientation and Arousal

Answer 11

o The Agitated Behavior Scale (Corringan, 1989; Corrigan & Bogner, 1994):

a. It’s useful for assessing individual’s recovering from severe injuries demonstrating slow emergence of cognition.
b. It’s helpful in monitoring time-related patterns of agitation and restlessness. .
c. It’s useful for documenting aggression when it’s a product of agitation and confusion.
d. It can give you a disinhibition score, aggression score, and lability score. Lability – appropriate laughter or crying. Disinhibition – do something completely inappropriate in social situations.

Question 12

Assessment of Cognitive Abilities: General Cognitive/Intellectual Abilities

Answer 12

o The Wechsler Adult Intelligence Scale- III (WAIS III) is the most widely used measure of general intellectual ability.
➢ Represents a composite of performance on variety of (1) retrieval of general information, (2) vocabulary knowledge, (3) abstract reasoning, (4) both verbal and nonverbal problem solving or reasoning tasks, (5) memory recall, and (6) tests involving psychomotor speed.
➢ WAIS-III gives four factor scores (1) verbal compression score, (2) perceptual organization score, (3) working memory, and (4) processing speed
➢ Verbal vs. nonverbal subtests the verbal subtests tend to be less sensitive to acquired brain damage, which means you may not be able to diagnose rightly.

Question 13

Assessment of Cognitive Abilities: Immediate Attention

Answer 13

Measures of forward and backward digit span are administered.
• Forward digit span (count 1-50, can look at two skills while doing this task) (1) immediate memory, and (2) sustained attention for a brief period
• Backward digit span (counting in reverse 50 to 1) (1) give you information about storage, and manipulation of numerical information, (2) divided attention, (3) working memory
• Nonverbal measures of spatial span are also sometimes used.

Question 14

Assessment of Cognitive Abilities: Focused Attention

Answer 14

• Cancellation tasks very in complexity, but usually consist of rows of characters containing randomly interspersed targets to be canceled (i.e., crossed out) as quickly as possible.
• Trail Making Test (Part A and Part B) switching from numbers to letters. (Page 103)

Question 15

Assessment of Cognitive Abilities: Sustained Attention

Answer 15

Measured by auditory or visual continuous-performance tests. e.g. Computer-based tasks such as the Conners Continuous Performance test; Digit Symbol Coding subtest of WAIS-III

Question 16

Assessment of Cognitive Abilities: Divided Attention

Answer 16

Brief Test of Attention requires the individual to listen to a string of numbers and letters and to count the number of letters in the string. Another example is Letter-Numbering Sequencing Subtest of the WAIS-III where an individual has to listen to a set of mixed letters and numbers and recite back first the numbers and then letters in order.

Question 17

Assessment of Cognitive Abilities: Alternating Attention

Answer 17

**

Question 18

Poor recall after initial word list presentation may be indicative of deficits in

Answer 18

(1) attention, (2) processing of information, (3) memory span or working memory

Question 19

Poor recall and recognition are indicative of

Answer 19

poor initial learning or limited ability to retain information in memory, once it’s processed and encoded.

Question 20

Ways to assess recognition?

Answer 20

Use words, phases, or designs and ask them to indicate those images. SCAN

Question 21

Executive Functions

Answer 21

o Commonly used tests (Pages 111-115): Wisconsin Card Sorting Test (helps in set shifting), Stroop Color and Word Test (helps set shifting and inhibition of prepotent/having exceptional power responses, page. 112), Tower test (helps with planning): London, Hanoi, Controlled Oral Word Association Test
o Executive functions are difficult to quantify so often a set of different tests are utilized to assess the related domains.

Question 22

General Measures of disability and outcome

Answer 22

o Functional Independence Measure (FIM; Grander & Hamilton, 1987): One of the most widely used test consisting of an 18-item ordinal scale.
• Assesses the level of assistance people need to perform various activities of daily living.
• Uses a 7-level scoring system with scores ranging from 126 (normal) to 18 (totally dependent).
• Correlates moderately well with Glasgow Outcome Scale.
• Sometimes may be used in conjunction with the Functional Assessment Measure (FAM; Hall, Hamilton, Gordon, & Zasler, 1993). Both these measures when used together are still considered as gross measures.
o The Disability Rating Scale for Severe Head Trauma (Rappaport, Hall, Hopkins, Belieza, & Cope, 1982): More sensitive than GOS and has fewer ceiling effects than the FIM and FAM.
• The Katz Adjustment Scale (Katz & Lyerly, 1963) assesses personality changes following brain injury and their psychosocial effects. It has 127 items, and it has both caregiver and patient report form. It detects changes following rehab, so after therapy, it can tell you how bad/different the changes are. (1) It consists of 127 items, (2) caregiver and patient rating forms, (3) detects changes following rehab, (4) correlates well with other measures

Question 23

Memory problems in mild vs. moderate-severe TBI

Answer 23

• Moderate to severe TBI: slow rate of learning, impaired delayed recall, cued recall, and recognition memory. Combination of both attention and memory issues.
• Mild TBI: no recall initially with more accurate performance over repetition. There is going to be no drop/deficits with delayed recall. They have intact memory and storage abilities. The problems are more due to attention deficits.

Question 24

Encoding

Answer 24

acquiring new information

Question 25

Retention

Answer 25

assessed by delayed recall

Question 26

Recognition

Answer 26

assessed by asking yes-no questions by previously presented items