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Human Neuro > Chapter 3 - Neuropsychological Assessment > Flashcards

Chapter 3 - Neuropsychological Assessment Flashcards

1
Q

What specialist performs assessments and administers tests to diagnose behaviors?

A

Neuropsychologists

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2
Q

What are the goals of a neuropsychological assessment?

A
  • diagnose presence of cortical damage (assess cog. function) and localize it
  • facilitate pt care
  • ID mild disturbances (microscopic damage)
  • ID unusual brain organization
  • ID cause of disorders
  • Rehab
  • Help pt and family understand their disorder
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3
Q

Psychometrics

A
  • Science of measuring human traits or abilities.
  • standardization of psychological and neuropsychological tests
  • neuropsychometrics are sensitive to behavior
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4
Q

Reliability

A
  • stability or dependability of a test score
  • test results can be reliable but not valid
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5
Q

Validity

A

whether or not the test is measuring what it is supposed to measure

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6
Q

Why is it important that neuropsychological tests be reliable and valid? ​

A

so that pts are not misdiagnosed

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7
Q

False Positive

A

test erroneously indicates a condition

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8
Q

Base rate

A

frequency w/ which a pathologic condition is diagnosed in the population tested

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9
Q

What types of test are most commonly used by psychologists?

A
  • achievement - how the ind. has profited from learning and experience (exams)
  • aptitude - future functioning (GRE, MCAT)
  • behavioral/adaptive - what the pt. habitually does (day to day tasks)
  • intelligence - IQ score, working mem., learning, verbal and nonverbal
  • neuropsychological - sensitive to all changes in brain
  • personality - diff personality traits, i.e. introvert vs. extrovert (MMPI)
  • vocational - opinions and attitudes regarding diff. areas like professions
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10
Q

Fixed battery

A
  • comprehensive and fixed set of tests
  • EX: Halstead-Reitan Neuropsychological Battery, Wechsler Adult Intelligence Scale, Luria-Nebraska Neuropsychological Battery
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11
Q

What are the pros and cons of a fixed battery?

A

Cons
- time-consuming, all tests must be conducted
- neuropsychologist may not have seen pt. if tests are given by a tech
- something could be missed, tests cannot be altered to assess all concerns

Pros
- patients are easy to compare and assess b/c tests are standardized

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12
Q

Flexible battery

A
  • selection and administration of an array of tests based on pt’s presenting complaints
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13
Q

What are the pros and cons of a flexible battery?

A

Cons
- patients cannot be easily compared
- possible bias could cause neuropsych. to miss a test
- no longer standardized

Pros
- tests can be changed/altered to fit concerns
- neuropsych. selects tests, giving the ability to hone in on specific traits

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14
Q

How does a neuropsych choose the test battery?

A
  • interview
  • background data
  • history of symptoms
  • medical history
  • family history
  • developmental
  • drug history
  • educational history
  • employment history
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15
Q

Orientation/Arousal

A
  • pt’s basic awareness of themselves to the world around them
  • assessment involves eval. of orientation in terms of place, person and time (What’s the date? What’s your address? What’s your name)
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16
Q

What is the standardized test for orientation?

A
  • Galveston Orientation and Amnesia Test (GOAT)
    • assess extent and duration of confusion and amnesia after TBI
    • 0-100, 75 or better indicates normal functioning
17
Q

Sensation and perception

A
  • assess pt.’s visual, auditory, and tactile functional levels
  • can be done by optometrist or audiologist
18
Q

What are the common tests for sensation and perception?

A
  • Halsteid-Reitan Neuropsychological Battery - standardized
  • includes a sensory-perceptual examination like tactile testing (feeling and ID objs) - nonstandardized
19
Q

Attention and Concentration

A
  • sustained attention - paying attention to something over prolonged period of time
  • selective attention - paying attention to more than one thing at a time
20
Q

What are the common tests for attention and concentration?

A
  • Symbol digit modalities test (SDMIT) - #s and symbols, must match each
  • d2 test - visual cancellation test
  • nonstandardized - digit span test (repeat numbers in instructed order), say the alphabet backwards
21
Q

Motor Skills

A
  • assess of pt.’s motor control in the upper and lower extremities
  • measuring simple and complex motor skills
22
Q

What is the common test for motor skills?

A
  • standardized - finger-tapping speed from the Halsteid-Reitan and grip strength
  • nonstandardized - follow motor commands
23
Q

Verbal Functions/Language

A
  • assess simple spoken language as well as more complicated areas like:
    • word repetition
    • naming
    • word production
24
Q

What is the common test for verbal functions/language?

A
  • standardized - the Controlled Oral Word Association (COWA) - name as many words you can starting w/ a specific letter
  • standardized - Token test - point and touch diff. colored tokens
  • nonstandardized - define words, generating sentences using a specific word
25
Q

Visuospatial Organization

A
  • assess diff. areas of processing such as spatial orientation, facial recognition, and visual sequencing
26
Q

What is the common test for visuospatial organization?

A
  • standardized - The Bender Gestalt test - copy geometric shapes, graded on accuracy
  • standardized - The Rey-Osterrieth Complex Figure Test - copy abstract shapes, graded on accuracy
  • nonstandardized - draw the face of a clock at a certain time, recognition of facial expressions
27
Q

Memory

A
  • immediate and delayed memory (verbal and visual formats)
28
Q

What is the common test for memory?

A
  • standardized - Wechsler Memory Scale (WMS) - measures verbal and nonverbal mem
  • nonstandardized - repeat a story, recall ability of specific words
29
Q

Judgement/Problem Solving

A
  • abstract reasoning/insight and problem solving
30
Q

What is the common test for judgement/problem solving?

A
  • standardized - Trail Making Test B, Wisconsin Card Sorting Test, Tower of London-Drexel University
  • nonstandardized - what-if situations
31
Q

What is the most common test for frontal lobe damage?

A
  • Wisconsin Card Sorting Test - sort cards depending on an unknown set of rules, pt. has to learn rules through trial and error
  • shifting of strategies
32
Q

Neuropsychological diagnoses provide info in areas such as:

A
  • mild head injuries
  • ADHD
  • learning disability
  • Alzheimer’s disease
33
Q

Malingering

A
  • exaggerating cognitive deficits
  • external incentives could play a role in performance (benefits, disability, lawsuits etc.)
  • neuropsych are trained specifically to detect this

Human Neuro (19 decks)

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