Chapter 13: Neuropsychological Assessment

Question 1

Neuropsychology

Answer 1

Study of brain-behavior relationships

Question 2

Difference between neurologist and neuropsychologist

Answer 2

Neurologist focuses on anatomy and physiology of brain

Neuropsychologist focuses on functional product (behavior and cognition) of CNS dysfunction

Question 3

Premise behind neuropsychology

Answer 3

Behavior has an organic basis and performance on behavioral measures can be used to assess brain functioning

Question 4

Uses of neuropsychology

Answer 4

Identify damaged areas of brain
Identify impairments caused by damage
Assessing brain function

Question 5

Common referral questions

Answer 5

Traumatic brain injury
Cerebrovascular accidents (example: stroke)
Tumors
Dementia and delirium
Neurological conditions

Question 6

Areas assessed by neuropsychologists

Answer 6

Problem solving
Planning
Task learning
Simple/complex motor tasks
Memory, recall, recognition
Attention

Question 7

A thorough assessment includes…

Answer 7

Higher order information processing
Anterior and posterior cortical regions
Presence of specific deficits
Intact functional systems
Affect, personality, behavior

Question 8

Fixed battery

Answer 8

Comprehensive, standard set of tests administered to everyone
Take a long time to administer (about 10 hours)

Question 9

Flexible battery

Answer 9

Flexible combination of tests to address specific referral question

Question 10

Most commonly used fixed battery

Answer 10

Halstead-Reitan Neuropsychological Test Battery for Adults (HRNB)

Question 11

How flexible batteries work

Answer 11

Clinicians select specific tests from all available tests based on referral question, familiarity with tests, client characteristics (intelligence, sensory issues, etc.)

Question 12

Brief screeners

Answer 12

Quickly administered tests that provide general information on functioning
Used to determine whether more testing is needed
Example: mini mental status exam

Question 13

Memory assessments

Answer 13

Memory is impaired in functional and organic disorders (forgetting recent events)
Can be used to discriminate between psychiatric disorders and brain injury (forgetting is common in brain injury but not in psychiatric disorders)

Question 14

Most commonly used memory test

Answer 14

Wechsler Memory Scale

Question 15

Continuous performance tests

Answer 15

Used to assess attention (ADHD diagnosis, etc.)
Boring tasks (press a key when an x shows up on the screen, etc.): measure how well person stays with them

Question 16

Executive function tests

Answer 16

Stroop task: measure ability to ignore reading word (name color of ink only)
Wisconsin card sort: measure adaptability to new rules
Delay discounting: measure ability to delay gratification in order to gain a greater outcome later on

Question 17

Motor function tests

Answer 17

Grip strength
Finger tapping test
Purdue pegboard (fine motor skills: put pegs on peg board, put washers on pegs)

Question 18

Sensory functioning tests

Answer 18

Clock drawing test
Facial recognition test
Left-right orientation
Smell identification
Finger orientation

Question 19

Language functioning tests

Answer 19

Measure ability to develop language skills and ability to use language

Question 20

Normative approach to interpretation

Answer 20

Compare current performance against normative standard

Inferences made within context of premorbid ability

Question 21

Ideographic approach to interpretation

Answer 21

Compare within the individual: compare current scores to previous scores or estimates of premorbid functioning

Question 22

How to estimate premorbid functioning

Answer 22

Prior testing
Reviewing records
Clinical interview (“What were you like beforehand?”)
Interviewing others
Demographic estimation (assuming that you were average)
Hold tests (tests that are resistant to brain damage, such as vocabulary- scores are used to estimate IQ)

Question 23

Pattern analysis approach to interpretation

Answer 23

Patterns across tasks differentiate functional/dysfunctional systems

Question 24

Pathognomonic signs

Answer 24

Signs that are highly indicative of dysfunction