Neuropyschological Testing Flashcards
what is a neuropsychologist?
- clinical psych training w/ additional specific training in cognitive and behavior assessment
- bridge the gap btwn psych and neuro
what is neuropysch training used for?
- TBI
- electrical abnormalities
- degenerative disorders (parkinson’s, alzheimers)
- physical abnormalities (CP, hydrocephalus)
list some electrical abnormalities neuropysch training is used for (3)
seizure disorders, migraine headache, atypical nerve conduction (MS)
additional neuropsych eval diagnoses (4)
- dx of fxn impairments such as dyslexia and ADHD
- chemical exposure including braining changes after meth use
- metabolic disorders like diabetes or PKU
- toxin exposure (lead)
first 3 steps in neuropsych eval
1) thorough background interview (history) - takes 1 hour to complete
2) cognitive and psych tests (takes several hours)
3) evaluate pt performance by interpreting scores with norms
steps 4-6 in neuropsych eval
4) dx formulation based on test results in a written eval.
5) treatment recommendations made based on pt performance
6) repeat testing may be done to document progress
total time for neuropsych eval
6 hours including interview, testing, scoring, interpretation, and written report
Test battery covers what domains (first 5)?
1) orientation and mental status
2) general intellectual fxning
3) attention and concentration
4) language
5) learning curve
Test battery memory aspects (6)
1) verbal memory
2) visual memory
3) working memory
4) immediate memory
5) delayed recall memory
6) recognition memory
additional test battery aspects
1) processing speed
2) academic achievement level
3) motor fxning
4) tests of effort (sometimes assess malingering)
5) emotional/personality fxning
Test battery: Multiple areas of executive/frontal lobe fxning (first 4 things)
1) problem solving
2) foresight and planning
3) ability to maintain set
4) perseveration
Test battery: Multiple areas of executive/frontal lobe fxning (3 things - descriptive)
1) ability to impose structure on ambiguous stimuli
2) abstract reasoning both verbally and visually
3) cognitive and behavioral impulsivity
PT and neuropsych
Neuropsychologists can be a resource to help the physical therapist define and identify ways that cognition and psychological function impact physical functioning.
It is critical to remember that adjustment to life after neurological change may impact the attitude of the patient and patient expectations.
Multiple Ability Self-Report Questionnaire (MASQ)
Self-report questionnaire about what the patient is having trouble with such as B/B fxn, incontinence, dressing yourself, writing your own checks. How aware is someone about what their deficits are?
orientation and mental status includes what info
date, place, time, who is the president now, etc
general intellectual fxning includes what info
history info, was the person a doctor or attorney previously,
learning curve
RAVLT - how long does it take you to learn the info you are trying to learn, how long can you maintain the info over time
delayed recall memory
how well can you recall something after a period of time
recognition memory
things presented in a story, how well can you pick out the words I asked you to remember before
processing speed
peg test, trailmaking test, how quickly can you connect lines between numbers
motor functioning
how well can you make your hand do what you want it to
tests of effort: who fails at this
those who are faking (malingering)
MMPI very useful in determining functioning of what?
emotion/personality functioning
- inkblot test also useful for this
define perseveration
stuck in one mode and can’t get out of it. #, letter, #, letter, # # # #
ability to maintain set is what
alternate between #, letter, # letter etc. do this and then forget if you were on # or letter = loss of set
Foresight and planning
A maze: you know where you are starting adn where you are going to end; can you make a strategy and plan to get there
What is the ability to impose structure on an ambiguous stimuli?
someone tells you to clean the house before you get home. Must make some kind of structure, such as I will clean the bathroom and then do the laundry. Can you come up with a structure for a vague task?
F.A.S. (**) test is looking at what type of impulsivity (COWAT Test: controlled oral word association test)
cognitive and behavioral impulsivity
