Chapter 28 - Neuropsychological Assessment Flashcards
What is the BIG question in neuropsychological assessment
Why are you doing it?
Not sure why you are doing the testing, don’t do it.
dont just look at testing, have to know the patient, know why you are doing the exam
Case R.L
rear-ended, hit head on window
week in hospital, dyslexic for words and music, no obvious brain damage in MRI
year later, symptoms not as bad, but still impairments and depressed over it all
assessment showed above average IQ but impairments on WCST and verbal fluency
What is a good neuropsychological test
one that answers the question of why
needs to be reliable (get same result multiple times)
valid (testing what you want it to test)
easy to administer and score
What does it mean to say that there are biopsychosocial effects related to assessment
injury does not occur in a vacuum, occurs in a real world meaning there is an interaction between actual injury, psychological factors (personality, values, etc), environmental factors (ex. culture)
compared to studying lab animals, that seems like it is in a more vacuum environment
What are the general types of test batteries
composite batteries = lots of tests, depends on type given to patient
standardized = every patient gets the same test
What is the problem with test batteries
they are more qualitative and not based on multivariate statistics
What are the Houston Guidelines for Clinical Neuropsychology
- Assessment
- Treatment and Interventions
- Consultation (patient, families, etc.)
- Research
- Teaching and Supervision
(all required to get registered as neurosphychologist)
What are some of the goals of neuropsychological testing
- aims to determine level of cerebral functioning and dysfunctioning
- facilitate patient care and rehabilitation
- identify mild disturbances when other studies are uncertain
- identify unusual brain organization (ex. left handers, kids with early brain injury)
- confirm an abnormal EEG in epilepsy
- document recovery (compensation)
- promote realistic outcomes
Why are intelligence tests necessary for neuropsychological testing
all performance tests are likely to be influenced or related to their IQ
provide clues, but are not definitive
How might co-morbidities affect neurospychological test results
cognitive and behavioural impairments can result from comorbidities
(therefore may not be direct result of injury)
What is the problem of effort in test results
sometimes people just do not want to do it, tests can take a long time, therefore effect test results
How can we identify faking memory loss
ex. get injury from work, so might want to make it so you do not have to go back to work
Hiscock test = 5 digit numbers, ask which one they have seen before
amnesics do just fine, people faking do badly
OR
ask people to guess what time it is, usually people capable of guessing within 10 minutes
What are symptoms of parietal injuries
apraxia - difficulty making specific movements
What are symptoms of temporal injuries
poor visual memory
personality
What are symptoms of frontal injuries
difficulty speaking, but can understand what is said to them
odd sense of humour