Exam Pool

Question 1

Describe the structure of the Wechsler Intelligence Scale for Adults Fourth Edition (WAIS-IV).

Answer 1

Question 2

The WAIS–IV consists of 10 core subtests on which (usually) Full Scale IQ (FSIQ) is based: The full-scale IQ is the index score that is considered the most representative of general intellectual functioning (g) The subtests are organized into four indices. Describe the 4 indices and name the subtests they contain

Answer 2

1. Verbal Comprehension (VCI) - This index reflects an individual’s ability to understand, use and think with spoken language. It also demonstrates the breadth and depth of knowledge acquired from one’s environment. It measures the retrieval from long-term memory of such information. a. Similarities (SI), b. Vocabulary (VC), c. Information (IN), 2. Perceptual Reasoning (PRI) - This index reflects an individual’s ability to accurately interpret, organize and think with visual information. It measures nonverbal reasoning skills and taps into thinking that is more fluid and requires visual perceptual abilities. a. Block Design (BD); b. Matrix Reasoning (MR), c. Visual puzzles (VP), 3. Working Memory (WMI) - This index reflects an individual’s ability to take in and hold information in immediate awareness and then perform a mental operation on that information. It also measures the mental manipulation of number operations. a. Digit Span (DS), b. Arithmetic (AR), 4. Processing Speed (PSI) - This index reflects an individual’s ability to process simple or routine visual information quickly and efficiently. It measures visual and motor speed. a. Symbol Search (SS), b. Coding (CD),

Question 3

What are the five additional and optional subtests:

Answer 3

1. Letter-Number Sequencing (LN), for working memory index (16-69only) 2. Figure Weights (FW), for perceptual reasoning index 3. Comprehension (CO), for verbal comprehension index 4. Cancelation (CA), for processing speed index (16-69only) 5. Picture Completion (PC) for perceptual reasoning index

Question 4

How you would go about analysing the results (i.e., not the scoring procedures) of a WAIS-IV assessment?

Answer 4

1. Assess overall intellectual ability by determining the FSIQ score, this will only answer the questions of whether the individual is intellectually gifted, has an Intellectual disability or low IQ or an average intelligence. Consider mentioning the GAI here? 2. Look for overall strengths and weaknesses in the four indexes 3. Evaluate index level discrepancy comparisons – i.e. looking to see if there is a significant difference between the performance on the indexes and whether or not it is unusual in the general population 4. Determine normative strengths and weaknesses in the index profile –by comparing to individuals of the same age 5. Evaluate personal strengths and weaknesses - refer to whether a person’s scaled scores on individual subtests differ significantly from their average performance across tests 6. Evaluate subtest level discrepancy comparisons –i.e. compare 2 subtest scores to inform the interpretation of an index score 7. Generate hypotheses about any fluctuations in WAIS – IV profile and consider referring for a WIAT assessment for further information  

Question 5

What is executive functioning?

Answer 5

• Higher-order cognitive skills required to initiate, plan, execute and monitor complex goal-directed activities • Describes the regulation and control of different cognitive processes that enable a person to successfully engage in independent, goal-directed, self-serving behaviour • The self-management system of the brain • Associated with the frontal lobes, in particular the prefrontal cortex

Question 6

Name two measures of executive functioning.

Answer 6

1. Wisconsin Card Sorting Test 2. Delis-Kaplan Executive Function System (D-KEFS)

Question 7

Describe the Delis-Kaplan Executive Function System (D-KEFS)

Answer 7

o Battery with 9 standalone tests o 8-89 years o 90 minutes testing time for full battery o Subtests include:  Sorting test  Trail-making test  Verbal fluency  Design fluency  Colour-word interference  Tower test  20 question test  Word context test  Proverb test

Question 8

Describe the Wisconsin Card Sorting Test

Answer 8

o Popular test of executive functioning o Developed by Berg in 1948 o Measure of perseveration:  Perseveration = repeating behaviours/strategies when not rational.  E.g. continually pressing button at level crossing  One manifestation of perseveration = persisting with strategy when environmental contingencies change, and strategy no longer adaptive. o Administration:  Client matches response card to stimuli cards.  Can match number, colour or form (shape).  Client not told pattern, just given corrective feedback  Pattern changes without warning after client maintains set of 10 consecutive correct responses. o Assesses:  Pattern recognition  Planning  Execution of plans  Self-monitoring  Self-correction  Flexible thinking and impulse control

Question 9

Describe some conditions with impaired executive function

Answer 9

• Major Neurocognitive Disorder -A decline in two or more cognitive domains -Severe functional impairment (e.g., ABAS) Alzheimer’s disease: memory, poor free recall AND recognition, poor consolidation Aphasia: difficulty understanding producing language Lewy body: attention, executive function, visuospatial (plus tremor/kinesia) Parkinsons: executive function, processing speed, procedural memory (plus tremor/kinesia) Huntingtons: executive function, visuospatial, memory retrieval, procedural memory (plus mania, involuntary movements) Multiple sclerosis: memory, information processing, verbal fluency, concentration/attention span. Obesity and binge eating

Question 10

Give me reasons why we measure intelligence.

Answer 10

 Cognitive potential/Neurological dysfunction o Aids diagnosis and intervention for intellectually disabilities o Provides access to funding and support, e.g., NDIS to improve quality of life  Inform educational or placement decisions  Developing interventions for education or vocational settings (e.g. intellectual disability, intellectual giftedness, confirming average intelligence) o Extra opportunities for learning o Making adjustment to education to cater to intellectual abilities, e.g., being moved up or down classes in skill levels to better support learning, providing additional equipment or resources to assist with specific impairments o Acquire teacher’s aide and/or teacher who is trained in delivering adjusted curriculums for individuals with intellectual or learning disabilities.  Research purposes o Learn more about intelligence and its long-term impacts on physical and mental health, and interpersonal and occupational functioning. o Learn about ways we can minimise potential negative effects with early and ongoing interventions.

Question 11

Describe the structure of the ABAS-3.

Answer 11

Structure • The Adaptive Behaviour Assessment System or ABAS-3 measures adaptive, or practical everyday skills needed to function in different contexts of daily life, like taking care of themselves and interacting with others. o Parent/Prim caregiver form, o Teacher/Day-care Provider, o Parent Form, o TeacherForm, o Adult Form, • ABAS-3 covers three broad domains: o Conceptual, o Social, o Practical • within these domains, it assesses 11 skill areas which focus on practical everyday activities required to function, meet environmental demands, care for oneself, and interact with others effectively and independently: 1. Communication: speech, language listening, conversation, and nonverbal communication skills 2. Community use: Behaving appropriately in the community, knowing where things are and how to get around in public places 3. Functional pre-academics: Basic pre-reading, pre-writing and pre-arithmetic skills such as knowing letters, numbers, and shapes 4. Health and safety: Following safety rules, showing caution when needed, staying out of danger, and knowing when to get help 5. Home or school living: Cleaning up around the house, helping adults with chores, taking care of personal items 6. Leisure: Playing with others, playing with toys, following rules in games, and planning fun activities 7. Self-care: Eating, dressing, bathing, toileting, grooming, and hygiene 8. Self-direction: Self-control, making choices, starting and completing tasks, following a routine, and following directions 9. Social: Getting along with others, expressing affection, making friends, showing and recognizing emotions 10. Work: Completing work tasks, working with supervisors, and following a schedule 11. Motor: Sitting, pulling up to a stand, walking, throwing, kicking, and fine motor skills such as writing and using scissors

Question 12

Describe the scores of the ABAS-3.

Answer 12

Scores Ratings: 3 (Always or Almost Always when needed) – 0 = Is not able. • Similar to WISC/WAIS à Raw scores, Scaled Scores, Index Scores à Domain Index scores: Conceptual, Social, Practical, global Adaptive Composite Score. • General Adaptive Composite summarises performance across all adaptive skills areas bar work. • Usually ABAS-3 is done in conjunction with WISC + dev history interview, clin observation, questionnaire etc.

Question 13

When would you use the ABAS

Answer 13

1. To assess/evaluate: Useful for evaluating people with/suspected of having developmental delays, autism spectrum disorder, intellectual disability (crit B about adapt functioning), learning disabilities, neuropsychological disorders and sensory or physical impairments. 2. To assess adaptive skills: 3. To assist diagnosis: in diagnosing/classifying various developmental, learning and behavioural disabilities and disorders. 4. To recommend appropriate intervention/treatment/training: identify strengths and weaknesses to assist with recommendations and intervention/developing treatment plans/training goals. 5. To document and monitor progress over time: 6. To get financial support: Help evidence eligibility for disability benefits, services and assistance and to evaluate the capacity for individuals to live/work independently.

Question 14

Describe the similarities and differences between the WAIS-IV and the SB-5. How are they alike, yet dissimilar?

Answer 14

Similarities: • Fairly similar in terms of scoring • Both produce a Full-Scale Intelligence Quotient (FSIQ) measuring the individual’s overall intellectual abilities • The five factor index scales on the SB-5 can be considered equivalent to the four composite scores on the WAIS-IV • Some overlap between the factor indexes in the SB-5 with the composite scores in the WAIS-IV as both scales include working memory and visual spatial indexes. Differences: • The SB-5 index scales also include fluid reasoning, knowledge, and quantitative reasoning factor indexes • Each of the five factors scales in the SB-5 include both verbal and non-verbal subtests used to calculate the verbal and non-verbal IQ respectively (not part of WAIS-IV) • The SB-5 includes routing subtests that are administered initially to help establish an individual’s level of ability and determine an appropriate starting point for the individual • Two routing subtests – one verbal and one non-verbal used to calculate the Abbreviated Battery IQ (ABIQ) • ABIQ provides a quick estimate of two major cognitive factors: fluid intelligence and crystallised ability • WAIS-IV standardised for both Australian and New Zealand norms and SB-5 only has US norms. • SB-5 has a lower floor and a higher ceiling compared to the WAIS-IV • Individuals who take the SB-5 are unlikely to find the test either too difficult or too easy • SB-5 appropriate for measuring the intelligence of gifted individuals as it has an extended version that allows for the calculation of IQs up to 225 • Both tests differ in terms of the age ranges for which they have been validated for: the SB-5 for ages 2-85 and WAIS-IV for ages 16-90

Question 15

Dr. Andrew believes his client (Lynda) may have a Specific Learning Disorder (SLD). Briefly explain how Andrew should go about establishing whether this is the case, making reference to DSM-5 criteria.

Answer 15

• The first DMS-5 criterion for Specific Learning Disorder (SLD) in the DSM-5 is having difficulties in learning and using academic skills that persisted for at least six months despite the provision of interventions targeting these difficulties o Depending on Lynda’s age, either Lynda or one of her caregivers should be interviewed about the presence of any learning difficulties and whether any interventions have been provided to assist with these difficulties o Difficulties may be in reading, comprehension, spelling, writing, or mathematical abilities • Should be determined if these learning difficulties cause significant interference with any areas of functioning including academic or occupational performance, activities, or daily living • Gain a thorough developmental, educational, medical, and family history from Lynda o May involve gaining access to any previous school reports or results from past tests conducted by other professionals • Administer psychometric tests to determine Lynda’s levels of intellectual functioning and academic abilities: o Intellectual abilities measured using either a WAIS or a WISC depending on her age o Academic abilities measured using WIAT • Administering these tests would allow for the satisfaction of two of the DSM-5 criteria for SLD: 1) That the affected academic skills are substantially below those expected for the individual’s chronological age • Lynda’s results on standardised tests will allow for comparisons to be made in relation to norms for her age group 2) Lynda’s results on a test of intellectual functioning would provide an indication of her overall intellectual ability, thus allowing for intellectual disability to be ruled out as a cause of Lynda’s academic abilities, if she scores within the average range. • Comprehensive assessment may be required to rule out other possible causes including visual or auditory issues • May require referrals to other professionals for further assessment.

Question 16

Imagine you had to teach students how to write a report outlining a cognitive assessment of a child, how would you do this? Describe in detail the three-hour workshop.

Answer 16

Explanation of function/purpose of psychological reports • Highlight that reports should positively impact and empower people by providing further understanding of their strengths and difficulties to the child, their family and their teachings • Need to be written in an accessible manner for this audience that provides clear explanation of the presenting problem and feasible recommendations of ways to address them • Emphasise that the findings of reports have important implications for the child’s life including accessing support, government funding, and medications • Importance of maintaining the client’s privacy by only communicating information relevant to the research question - Use examples of how this could be done both poorly and effectively Components of a psychological report • Reason for referral • Background information • Observations during assessment • Test information • Results - Information that would be useful to include in the results section: percentiles rather than standard scores, confidence intervals, and descriptive classifications • Summary • Recommendations - Examples of different types of recommendations that would be appropriate to make • Provide examples of each section being written in both a poor and effective manner Report writing practice and feedback • Remaining time in class spent practising writing the different sections of a report • Providing students with feedback on what they have done well/ areas they could improve.  

Question 17

Describe the ethical issues associated with testing and assessment (specifically refer to relevant Codes and Guidelines). What are the benefits of psychologists engaging in ethical practice around testing and assessment? What are the risks if psychologists don’t act ethically?

Answer 17

• According to the APS guidelines for psychological assessment and the use of psychological tests (2018): • Psychological assessment is a core competency for all psychologists • Psychologists conduct psychological assessments for a wide range of purposes across a broad range of contexts, and often with a growing range of assessment methods. • Psychologists need to keep up to date with developments in assessment (e.g. new methods) • Psychologists must ensure they obtain informed consent, outline the limits to confidentiality, and manage client relationships respectfully • Psychologists are qualified and competent in the selection, administration, interpretation, integration and reporting of the results of psychological assessments, and are aware of the risks associated with unsupervised or blind testing. • Psychologists are aware that clients test performance can be adversely affected by language barriers, cultural background and physical or mental conditions • Psychologists consider assessment data in the context of other relevant information about the client and the circumstances in which the assessment was conducted. • Psychologists maintain the security of psychological tests and other assessment materials and limit access to those who have the appropriate qualifications and training. They are also responsible for the use of psychological tests by their students. • Psychologists keep themselves up-to-date with developments in assessment and testing which relate to their area of work. Benefits • Providing valid and reliable testing and accurate reporting of results • Being competent in testing • Can be aware of the how cultural background can affect scores and respecting people’s differences Risk • Wrong test administered • Exposing the client to a test that they didn’t need and therefore they cannot sit it for a certain amount of time (e.g. WISC/WAIS two years) • If tests aren’t administered correctly, they will not be standardised, reliable or valid • Not being supervised cause pose risks to the client and to the results they receive  

Question 18

Describe the 6 successive level approach to interpretation of the WISC-V. What are the benefits of this approach?

Answer 18

Level 1 – FSIQ Level 1 involves interpreting the FSIQ which is the best index of general intelligence (i.e., intellectual giftedness, intellectual disability or low IQ, average intelligence). It allows for the description classification of intellectual level relative to same age peers to be obtained. Level 2 – Primary Index scores Level 2 involves interpreting and comparing performance in each primary index scores (VCI, VSI, FRI, WMI, PSI) and comparing against select other index scores to develop hypotheses about the child’s performance. Level 3 – Primary subtest scaled scores Level 3 involves interpreting the 10 primary subtest scales scores & differences between the scores and the mean of the 10 primary subtests scores. This allows for hypotheses about the child’s strengths & weaknesses to be developed. Level 4 – Inter-subtest and inter-process score variability Level 4 involves the interpretation and comparison between sets of subtests scales scores, process scores and among clusters of scales scores. These comparisons are open to errors. This allows for the development of hypotheses about the child’s intellectual abilities. Level 5 – Intra-subtest variability Level 5 involves the interpretation of the patterns of raw scores within each subtest, revealing a pattern of successes and failures. This is made easy to interpret as items are arranged in order of difficulty. Level 6 – Qualitative Analysis Level 6 involves the analysis of content of responses and specific item failures and developing hypotheses. E.g., a child that is performing well on a subtest but comments “I’m worthless” may be experiencing performance anxiety. Benefits: The successive-level approach to test interpretation allows for a better understanding of a child’s performance on the WISC-V. It provides both quantitative and qualitative data and analysis of both general and specific areas of intellectual functioning. This approach can readily be applied to other Weschler tests (WAIS/WPPSI) and also other standardised tests (e.g., ABAS).

Question 19

What is cognitive remediation therapy, what are the mechanisms and for what conditions is it used for?

Answer 19

• CRT is a manualised intervention that consists of mental exercises aimed at improving cognitive strategies, thinking skills and information processing through practice. It is not about the content of the thoughts but is about the process. • This refers to the nonpharmacological methods of improving cognitive function in people with severe mental disorders. CRT can be delivered via computerised programs of varying length and complexity or can be undertaken one-on-one by a trained clinician. • Cognitive impairment is common in patients with mental disorders. At present, one of the only effective ways to improve cognitive impairment is CRT. CRT is a method based on behaviour training in order to sustainably and widely improve cognitive activities (attention, memory, executive function, etc). Recently, there has been a development of computer technology, the Computerised remediation therapy (CCRT) which has been derived from CRT. CCRT is a way to improve cognitive function by training individual brain specific brain circuits, which is based on the neural plasticity of the individual. Compared with CRT, CCRT can be more standardized, affordable, non-invasive and the treatment makes possible real-time adjustment of treatment difficulty and accurate recording of the training results. • In general, CRT content includes repetitive exercises, strategies for how to make up for cognitive defects and how to extend training tasks to everyday learning work. • Can be used for Schizophrenia, used to improve anxiety disorder, depression, eating disorders, schizoaffective disorder, mild cog impairment/cognitive functioning, psychiatric symptoms, and the daily functioning of patients with early stage dementia.

Question 20

Describe the use of the MOCA and the MMSE. What are the differences between these two measures?

Answer 20

• MMSE: 30-point questionnaire to screen for cog impairment and dementia. It assesses global cognitive status. It is well known by most practitioners and is easily administered. Any score of 24 or more (out of 30) indicates a normal cognition. Below this, scores can indicate severe, moderate, or mild cognitive impairment. Should not be used if first language is not English, or less than grade 8 education. • MOCA: 30-point questionnaire to screen for cognitive impairment and dementia. It assesses global cognitive status. MOCA is similar to the MMSE, but more sensitive. It screens all domains, including executive function. It requires specific training and certification to administer. Scores on the MOCA range from 0 to 30, with a score of 26 and higher generally considered normal. Differences • The MOCA DOES evaluate executive functioning, MMSE does not. • MMSE is not sensitive for early stages (patients with only minor cognitive impairment may be overlooked if this is the principle screening tool used), MOCA is more sensitive (may pick up things that the MMSE would miss) • MOCA more widely used. • MMSE is likely the better test for more severe cases as it is not as difficult as the MOCA. Similarities • Used in clinical practice as a quick screen for Alzheimer’s disease or mild cog impairment.