Chapter 7: Test Administration, Interpretation, and Issues in Assessment Flashcards
Neuropsychological assessment is broadly defined as _____.
A) the application of standardized testing techniques to understand and measure underlying brain-behavior relationships
B) measuring the impact of psychological adjustment on people with neurologic disease
C) nonimaging-based assessment of structural or evolving lesions of the CNS
D) the assessment of the impact of CNS factors in psychological functioning
A - the application of standardized testing techniques to understand and measure underlying brain-behavior relationships
Neuropsychological assessment involves application of standardized assessment testing techniques to the evaluation of current functioning in cognitive, behavioral, and emotional domains and integration of the influences of CNS disease and trauma to understanding performances on neuropsychological tests.
In a deficit measurement model of neuropsychology assessment, a person’s performance on a test can be evaluated relative to some external standard. Evaluation of a person’s performance relative to a population or sample is called ______.
A) incremental deficit standard
B) normative comparison standard
C) individual comparison standard
D) standard individual measurement
B - normative comparison standard
The normative comparison evaluates an individual’s performance relative to a larger, normally distributed group that is typically as closely matched for demographic variables such as gender, age, and education as possible. This comparison is one way an individual’s performance can be evaluated relative to a larger, known group.
Estimating premorbid functioning based on educational and occupational history is an example of _________.
A) actuarial estimation of premorbid functioning
B) current performance method of estimating premorbid functioning
C) best performance method of estimating premorbid functioning
D) demographic method of estimating premorbid functioning
D - demographic method of estimating premorbid functioning
Estimation of cognitive functioning can be done either by using
- pre-accident demographic variables such as SES, education, or occupational functioning
- current test performances that are known to be resistant to changes
- combined - demographic and current test performances
Parametric statistics rely on the assumed validity of the central limit theorem, which states that the attribute being assessed is normally distributed in the population and/or normative sample such that the distribution approximates a normal curve. Which type of data violates this assumption?
A) ordinal data
B) interval data
C) ratio data
D) continuous variables
A - ordinal data
Data can be nominal, ordinal, interval, or ratio in type.
Only interval and ratio data are appropriate for applying parametric statistics.
Both nominal and ordinal data describe broad categories such as impaired–normal or mild-moderate-severe, which do not have equal distance between intervals on the scale and do not have a beginning or end point. This makes them inappropriate for use with standard scores.
Minimum test requirements for psychological and neuropsychological tests require sufficient reliability and validity. Although many types of reliability and validity have been described to evaluate performance of a test, a basic understanding regarding the relationship between the concepts of reliability and validity is characterized as ____.
A) reliability is more important than validity
B) a test with good validity can have poor reliability
C) a test must have reliability to have validity
D) validity is more important than reliability
C - a test must have reliability to have validity
Reliability is critical for test validity, and a test cannot demonstrate validity without prerequisite reliability
Positive predictive value (PPV) is defined as the ____.
A) true positive divided by (true positives plus false positives)
B) percentage of true positives that can be reliably identified by a test
C) absolute number of true positives out of all cases tested
D) absolute number of true positives and true negatives in all cases combined
A - true positive divided by (true positives plus false positives)
Positive predictive value is a measure of the accuracy of a positive finding of a test. It is defined as the percentage of true positives divided by true positives and false positives.
Iverson and Brooks (2011) identified the base rate at which low scores (defined as less than the 5th percentile) occur in the healthy normative population for the Neuropsychological Assessment Battery (NAB), Extended Halstead Reitan Neuropsychological Batter (E-HRNB), and the WAIS-III/WMS-III. This research identified such low performance occurring on two or more subtests within each battery at what rate?
A) frequently (48.5-28% of the time in the normal group)
B) sometimes (15.2-10.4% of the time in the normal population
C) infrequently (5.0% of the time in the normal group)
D) rarely (<1% of the time in the normal group)
A - frequently (48.5-28% of the time in the normal group)
Performances occurring at the 5th percentile or lower are common in a battery of tests. Their occurrence is demonstrated to be high across a wide variety of neuropsychological batteries and tests and should be expected when using multiple measures.
The statistical probability of an observed difference between test scores, either within scales of a test or across different tests, is determined by relative rarity of a difference in scores based on the central limit theorem and its related to the test(s) reliability and standard error of measurement. This statistical difference is based on the assumption of ______.
A) heterogeneity of variance between the tests
B) homogeneity of variance between tests
C) a minimal correlation between the scales or tests
D) the ability to reject the null hypothesis
B - homogeneity of variance between tests
Variability in test performance refers to the reason (or variables) that test performance is similar or different among individuals. For ex, ppl with TBI often share a common source of variance in measured abilities, such as processing speed.
The concept of homogeneity of variance states that these “variances in common” among similar groups should vary predictably based on their cause and are thus termed homogeneous.
Both statistical performance and base rates in test performance are affected by all the following moderator variables, EXCEPT ____.
A) age
B) education
C) race
D) religion
D - religion
Moderator variables are variables that systematically affect performance but that are not the variable of measurement in interest.
Exs: age, education, and SES can affect performance on many neuropsychological tests.
Moderator variables, to the extent known, should be considered in the interpretation of neuropsychological test performance. Religion is not a significant moderator variable in neuropsychological tests.
The WAIS-IV has index scores with a mean of 100 and a SD of 15 points. The minimum difference required for statistical significance (p
D - 8-9 points (varies by age group); 22 points
The statistical difference in WAIS-IV VCI and PRI scores is based on central limit theorem and derives statistical significance based on the mean and standard deviation of standardized scores.
The much larger difference in scores needed to be a rare score, as defined as being observed in 5% or less of the population, is based on Bayesian statistics and observation of normal variation in VCI and PRI scores within the normative sample across different age groups.
DEFINITION:
Evidence-based neuropsychology practice
providing care that integrates clinical data, research literature, individual patient characteristics, financial realities, and cultural/social norms and values.
DEFINITION:
Comparison Standard
An established benchmark or score against which scores or behaviors are compared to determine if a difference exists.
The comparison standard is the value against which all other scores are compared to determine if meaningful differences from the value exist. A comparison standard may be normatively based (determined from an appropriate population) or be an individual comparison standard (determined from the individual’s history, demographic characteristics, or obtained from prior cognitive, achievement, behavioral, or other laboratory value.
It serves as a basis for the deficit measurement model to determine if there is meaningful difference between scores.
DEFINITION:
Individual Comparison Standard
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DEFINITION:
(Normative) Comparison Standard
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DEFINITION:
Deficit Measurement Model
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