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PSY4AAI > Week 5 - Cognitive Assessment: WAIS-IV > Flashcards

Week 5 - Cognitive Assessment: WAIS-IV Flashcards

1
Q

what are the 6 main factors to consider when choosing between assessment tools?

A
  1. The scope including the range of attributes that are covered by the test and the range of people with whom it can be used
  2. The reliability or accuracy of the measure
  3. The validity or the relevance of the measure
  4. The acceptability to potential users
  5. The practicality of the test regarding costs, equipment and facilities
  6. The fairness of the test to various groups of people
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2
Q

what is standardisation?

A
  • Ensures that all conditions are as similar as possible for all individuals who are given the test
    o i.e., that the normative sample is directly comparable to the person being assessed
  • Also ensure that no matter who gives the test and scores it, the results should be the same
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3
Q

what are some difficulties with standardisation?

A
  • weird acronym (Western, educated, industrialized, rich and democratic)
  • experimenter effects
  • individual differences
  • variability in IQ
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4
Q

questions to assess the applicability of a normative sample?

A
  • How large is the sample?
  • When was the sample gathered?
  • Where was the sample gathered?
  • How have the individuals been selected for the sample?
  • Who tested the sample?
  • How did the examiners qualify to do the testing?
  • What was the composition of the normative sample in terms of:
    o Age, sex, ethnicity, race or linguistic background, education, SES, geographical distribution, any other pertinent variables?
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5
Q

who is sir Francis Galton (1869-1883) and what did he do?

A
  • Studied adults and interested in giftedness
  • Developed first comprehensive test of intelligence
  • Sensorimotor: reaction time, strength of squeeze, keenness of sight
    o Measure of intelligence?
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6
Q

who is Alfred Binet (Henri and Simon) and what did he/they do?

A
  • Investigated individual difference in children and development of mental organisation
  • 1905 – Binet-Simon intelligence test
  • 1908 – revised to include age levels
  • 1911 – revised to include older adolescents and adult
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7
Q

who is Lewis Terman and what did he do?

A
  • Translated and adapted Binet-Simon for use in the US
  • Stanford Revision and Extension of the Binet-Simon Intelligence Scale (Terman, 1916) – Stanford Binet
  • Viewed intelligence tests as useful for detection of intellectual impairment or superiority
  • Potential for determining “vocational fitness”
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8
Q

how was intelligence testing used in WWI?

A
  • Use of intelligence tests in selecting officers and placing enlisted men in types of service
    o Validating tests on large samples: 1,726,966 men (Vane & Motta, 1984)
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9
Q

who is David Weschler and what did he do?

A
  • gained testing experience in WWII
  • took tests developed by others for non-clinical purposes to develop a clinical test battery (paired verbal tests with non-verbal tests)
  • viewed intelligence tests as dynamic clinical instruments
    o advocated for administration of a standard battery of both verbal and non verbal tests
    o when standardising his test, put emphasis on socio-economic background rather than regional representation
  • developed the Weschler test based on practical and clinical perspectives rather than theory
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10
Q

what is the history of the Wechseler scales and their demographics?

A
  • Wechsler-Bellevue I (1939): ages 10-79
  • WAIS (1955): ages 16-64
  • WAIS-R (1981): ages 16-74
  • WAIS-III (1997): ages 16-89
  • WAIS-IV (2008): ages 16-90
  • Wechsler-Bellevue II (1946): ages 10-79
  • WISC (1949): ages 5-15
  • WISC-R (1974): ages 6-16
  • WISC-III (1991): ages 6-16
  • WISC-IV (2003): ages 6-16
  • WPPSI (1967): ages 4-6.5)
  • WPPSI-R (1989): ages 3-7.3
  • WPPSI-III (2002): ages 2.6-7.3
  • WPPSI IV (2014)
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11
Q

what revisions were made in the WAIS-IV?

A
  • Update theoretical foundations
  • Update the norms/Flynn effect
  • Increase developmental appropriateness
  • Increase user-friendliness
  • Enhance clinical utility
  • Decreased reliance on timed performance
  • Enhancement of fluid reasoning and working memory
  • Strengthening framework based on factor analysis, including CFA
  • Statistical linkage to other measures, notably the Wechsler Memory Scale (WMS-IV)
  • Extensive reliability and validity testing
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12
Q

????? update theoretical foundations

A
  • Eliminate dual IQ/index score structure
    o Consistent with WISC-IV
  • Enhance measure of fluid intelligence
    o Develop additional measures of fluid reasoning: Figure Weights
  • Enhance measure of working memory
    o Revise arithmetic and digit span to emphasise WM
  • Enhance measure of processing speed
    o Develop additional PS subtests: Cancellation
  • Enhance theoretical foundations of the scales
    o Focus upon CHC theory (but not as much or as closely as Keven McGrew’s Woodcock Johnston)
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13
Q

Structure of the WAIS-IV

A 
GAI
- Verbal Comprehension (VCI)
o similarities
o vocabulary
o info
o comprehension
- Perceptual Reasoning (PRI)
o block design
o matrix
o reasoning
o visual puzzles
o figure weights
o picture completion
CPI
- working memory (WMI)
o digit span
o arithmetic
o letter-number sequencing
  • processing speed (PSI)
    o symbol search
    o coding
    o cancellation
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14
Q

what are factors that are not well measured (or at all) by the WAIS-IV?

A
  • Auditory or spatial memory or new learning
  • Creativity
  • Daily living skills
  • Facial recognition/processing
  • Bodily-kinaesthetic intelligence
  • Musical intelligence
  • Planning ability
  • Practical (inter-personal) intelligence
  • Intra-personal intelligence
  • Receptive vocabulary
  • Emotional intelligence
  • Visual closure and gestalt
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15
Q

What is the Flynn effect?

A
  • On average, American children/adults, have increased scores on intelligence tests at the rate of 3 points per decade (1930s to 1990s)
    o 5 to 8 points per decade for other developing nations, i.e. France, Netherlands and Japan
  • Post-2000 data from Norway and Denmark, suggest that FE has stopped
    o Potential decline, especially in Denmark
    o But data only based on 18/90 yo males
  • Zhou and colleagues found that individuals with IQ > 110 had smaller FE
  • adults 55-90 had larger FE
  • on Bayley Scales, infants and toddlers showed reverse FE (scores dropped 6.3 per decade)
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16
Q

What could be contributing to the Flynn Effect?

A

population size increasing

growth of cities

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17
Q

what is the standardisation of the WAIS-IV?

A

N = 2,200
o Selected based on 2005 US Census data
o Stratified according to age, sex, race/ethnicity, geographic region, and educational level
o 200 examinees per age band for 16-69 years o 100 examinees per age band for 70-90 years

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18
Q

WAIS-IV Reliability Scores

A

BLOCK DESIGN

  • split-half reliability (.87)
  • test-retest reliability (.80)
  • g loading (.68)
  • strength of g as measure (fair)

SIMILARITIES

  • split-half reliability (.87)
  • test-retest reliability (.87)
  • g loading (.68)
  • strength of g as measure (fair)

DIGIT SPAN

  • split-half reliability (.93)
  • test-retest reliability (.83)
  • g loading (.69)
  • strength as measure of g (fair)

MATRIX REASONING

  • split-half reliability (.90)
  • test-retest reliability (.74)
  • g loading (.73)
  • strength as measure of g (good)

VOCAB

  • split-half reliability (.94)
  • test-retest reliability (.89)
  • g loading (.72)
  • strength as measure of g (good)

ARTHMITIC

  • split-half reliability (.88)
  • test-retest reliability (.83)
  • g loading (.78)
  • strength as measure of g (good)

SYMBOL SEARCH

  • split-half reliability (.81)
  • test-retest reliability (.81)
  • g loading (.54)
  • strength of g as measure (fair)

VISUAL PUZZLES

  • split-half reliability (.89)
  • test-retest reliability (.74)
  • g loading (.66)
  • strength of g as measure (fair)

INFO

  • split-half reliability (.93)
  • test-retest reliability (.90)
  • g loading (.65)
  • strength of g as measure (fair)

CODING

  • split-half reliability (.86)
  • test-retest reliability (.86)
  • g loading (.55)
  • strength of g as measure (fair)

LETTER-NUMBER SEQUENCING

  • split-half reliability (.88)
  • test-retest reliability (.80)
  • g loading (.66)
  • strength of g as measure (fair)

FIGURE WEIGHTS

  • split-half reliability (.90)
  • test-retest reliability (.77)
  • g loading (.77)
  • strength as measure of g (good)

COMPREHENSION

  • split-half reliability (.87)
  • test-retest reliability (.86)
  • g loading (.68)
  • strength of g as measure (fair)

CANCELLATION

  • split-half reliability (.78)
  • test-retest reliability (.78)
  • g loading (.38)
  • strength of g as measure (poor)

PICTURE COMPLETION

  • split-half reliability (.84)
  • test-retest reliability (.77)
  • g loading (.57)
  • strength of g as measure (fair)

VCI

  • split-half reliability (.96)
  • test-retest reliability (.96)

PRI

  • split-half reliability (.95)
  • test-retest reliability (.87)

WMI

  • split-half reliability (.94)
  • test-retest reliability (.88)

PSI

  • split-half reliability (.90)
  • test-retest reliability (.87)

FSQI

  • split-half reliability (.98)
  • test-retest reliability (.96)
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19
Q

What are the differences between whites and African Americans on the WAIS-IV? Weiss et al., 2010

A
  • FSIQ differed as function of birth cohort
    o 19 pts for those born 1917-1942 vs. 10 points for 1988-1991
    o Race difference almost twice as large for older cohorts
  • IQ difference reduced when controlling for mediating variables: education, occupation, income, region, and gender
  • Variable of race accounted for 15% variance in IQ
    o Educational attainment (29%)
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20
Q

what are the differences between whites and hispanics on the WAIS-IV? Weiss et al., 2010

A
  • FSIQ different by birth cohort
    o 18 pts for those born 1917-1942 vs. 9 pts for 1988-1991
  • Difference reduced when controlling for mediating variables
  • Ethnicity accounted for 11% variance in IQ
    o Educational attainment (31%)
21
Q

what are the three types of scores in the WAIS-IV?

A
  • Raw scores
    o Meaningless alone
  • Scaled scores
    o Subtest level, norm referenced by age
    o Mean 10, SD 3
  • Index scores
    o FSIQ, VCI, PRI, WMI, PSI
    o Norm referenced by age
    o Mean 100, SD 15
22
Q

what are process scores for the WAIS-IV

A 
- scaled (norm referenced)
o block design no time bonus (BDN)
o digit span forward (DSF)
o digit span backwards (DSB)
o digit span sequencing (DSS)
- raw
o longest digit span forward (LDSF)
o longest digit span backward (LDSB)
o longest digit span sequence (LDSS)
o longest letter number sequence (LLNS)
23
Q

how are psychological tests often distributed in scoring?

A
  • Psychological tests often have non-normal distributions
  • Negatively skewed
  • Affects reliability
  • Standard scores may be misleading, so percentiles have to be used
24
Q

what is the FSIQ?

A
  • full scale intelligence quotient
  • global estimate of current cognitive ability
  • most reliable score on the WAIS-IV
  • mean split half reliability coefficient of .98 and stability coefficient of .96
  • standard error of measurement of 2 points
  • best overall measure of ability
  • converting to percentile can aid interpretation
  • important for ID determination
25
Q

what is the most reliable score on the WAIS-IV?

A

FSIQ

26
Q

what is the GAI

A

GAI = General Ability Index

  • The GAI is an optional index score for the WAIS-IV (Appendix C Tech Manual)
  • The GAI is derived from the core Verbal Comprehension and Perceptual Reasoning subtests.
  • The GAI provides an estimate of general intellectual ability, with reduced emphasis on working memory and processing speed relative to the FSIQ, i.e. the skills most affected by ABI
  • It can therefore be more appropriate to use the GAI when a WMI or PSI deficit exists
  • Theoretically, the GAI represents an individual’s overall cognitive ability, if working memory and processing speed abilities were similar to verbal and non-verbal abilities.
27
Q

what is the CPI?

A

CPI = Cognitive Proficiency Index

  • The CPI is an optional index score for the WAIS-IV (need the CD ROM from Lichtenberger & Kaufman’s “Essentials” book)
  • The CPI is the counterpart to the GAI. It is derived from the core Working Memory and Processing Speed subtests.
  • Theoretically, the CPI represents an individual’s proficiency at cognitive processing.
  • Efficient cognitive processing frees-up cognitive resources for more complex or higher-level tasks
  • Not 100% agreement – e.g. Hebben (2009) believes the two aspects of performance are quite distinct from each other
  • Perhaps it is more appropriate to just measure Working Memory and Processing Speed separately??
28
Q

what is the intelligent testing philosophy?

A
  1. Subtests measure what the individual has learned
  2. Subtests are samples of behaviour and are not
    exhaustive
  3. Standardized, individually administered tests assess mental functioning under fixed experiment conditions
  4. Test batteries are optimally useful when interpreted from a theoretical model
  5. Hypotheses generated from the test profile should be supported with data from multiple sources
29
Q

what should diagnostic decisions be based on in the WAIS-IV

A

test data, clinical observations, background information, data from other assessments, and referral questions

30
Q

what is the examiners main role in the WAIS-IV

A

Examiner’s main role is to generate hypotheses pertaining to strengths and weaknesses

The focus of any assessment is the person being assessed, not the test.

31
Q

what is Kaufman’s method?

A
  • Emphasises cluster scores and de-emphasises individual sub test scores in the interpretive steps
  • Uses base rate data to evaluate the clinical meaningfulness of clustering index called variability
  • Ground interpretation in theories of cognitive abilities (e.g. Cattell-Horn-Carroll’s (CHC) theory and neuropsychological theory) and in the cognitive neuroscience research that forms the theoretical basis for the WAIS-IV
  • Provides guidance on the use of supplemental measures to test hypotheses about significant subtest variation or outlier scores
  • Permits thorough theory-based profile interpretation for elderly individuals (ages 70 to 90) as well as for individuals ages 16 to 69 (Lichtenberger & Kaufman, 2012; p. 152)
32
Q

step 1 of interpreting the WAIS-IV

A
  • Report Standard Scores and Subtest Scaled scores
  • Create a table of standard scores FSIQ, VCI, PRI, WMI, PSI
  • Select whether to use 90% or 95% confidence intervals Should always report scores with 95% Cis
- Consider descriptive category Extremely low ≤ 69
Borderline 70 to 79
Low average 80 to 89
Average 90 to 109
High average 110 to 119 
Superior 120-129
Very superior 130+
33
Q

step 2 of interpreting the WAIS-IV

A
  • Determine the best way to summarise overall intellectual ability (FSIQ vs. GAI)
  • FSIQ
    o Most reliable score on the WAIS-IV
    o Mean split half reliability coefficient of .98 and stability coefficient of .96
    o It has a standard error of measurement of 2 points
    o Best overall measure of ability, thus represents the most sensible
    measure of overall functioning
    o Not however, meaningful in a neuropsychological sense; rare that one would want a point estimate of IQ but it is important for ID determination
  • General Ability Index (GAI)
    o Summary score less sensitive than FSIQ to working memory and
    processing speed, i.e., the skills most affected by ABI
    o More appropriate to use the GAI when a WMI or PSI deficit exists
    o Such cases would include a significant and unusual discrepancy between
  • VCI and WMI
  • PRI and PSI
  • WMI and PSI
  • Discrepancy between subtests within WMI and/or PSI
    o If there is such a discrepancy, GAI is a more accurate measure and should be used in preference (but not for ID determination)

Step 2a:
o Consider the 4 indices, subtract the lowest from the highest: is the size of the standard score difference <1.5SDs (<23 points)?

  • If YES, then FSIQ can be interpreted and should be employed
  • If NO, the FSIQ should not be interpreted as the summary and proceed to Step 2b

Step 2b:
o Is the GAI interpretable? Is the size of the standard score
difference between VCI and PRI <1.5 SDs (<23 points)
- If YES, the GAI can be interpreted and should be employed
- If NO, then neither FSIQ or GAI should be interpreted as the summary as they are not meaningful

Step 2c: calculating GAI
o Sum scores for similarities, vocabulary, information, block design, matrix reasoning and visual puzzles
o Consult the table in the manual

34
Q

step 3 of interpreting the WAIS-IV

A

determine whether the difference between the persons GAI and CPI is unusually large

3a: determine whether GAI and CPI each represent unitary abilities/processes and are interpretable
- GAI: is difference between VCI and PRI <1.5SDs (<23 points)?
- CPI is difference between WMI and PSI <1.5SDs (<23 points)?
o if YES, CPI can be calculated and interpreted, and GAI-CPI comparison made
o if NO, GAI-CPI comparison cannot be made

Step 3b: compute CPI
o Sum scaled scores for subtests of WMI and PSI
o Use Appendix A.2 from the “Essentials of WAIS-IV Assessment” book to calculate Index, percentile rank and confidence interval.

35
Q

Step 3c and d of interpreting the WAIS-IV

A

Is there a statistical difference between the indices (p

36
Q

Step 4 of interpreting WAIS-IV

A

Determine the path of interpretation:

  1. Interprets the WAIS-IV indexes via a four index model
    o This path will skip steps 6 & 7
  2. “Keith” model – requires Figure Weights and Letter-Number Sequencing and applies to ages 16-69 only
  3. “Core” model – requires only 10 core subtest and applies to full age range, 16 to 90 years
37
Q

step 5 of interpreting the WAIS-IV

A

Why do we want to interpret at the index level over the subtest level?
o Overall reliability coefficients of sub-tests range from 0.78 to 0.93

  • Digit Span, Matrix Reasoning, Vocabulary, Information, and Figure
    o Weights: very high >.90
  • Reliability coefficients of Cancellation and Symbol Search, are the lowest (0.78 and 0.81)
  • IQ and Index Scores range from 0.90 to 0.96, i.e., consistently higher than any sub-test, thus more reliable
    o Index scores are determined by combination of theoretical considerations and psychometrics
    o Most reliable decisions are made using the most reliable data
  • It is important at this stage to check for significant scatter within the indices to determine whether each is measuring a unitary construct
  • This range can be computed by subtracting the lowest score from the highest score to obtain a range
  • If the discrepancies are ≥ 5 pts, then the index cannot be considered unitary and therefore should not be interpreted as a single construct
  • Does not mean that you can’t interpret the performance, just that it needs to be cautiously interpreted
  • Determine whether there is a substantial difference between scaled scores composing the index

Step 5a:
o Determine whether the size of the differences among the sub test scaled scores within the VCI is too large (i.e., the differences are greater than 1.5 SDs, i.e. ≥5 points)
- If YES, then the Index is unitary and can be interpreted
- If NO, then the difference is too large and cannot be interpreted as
a unitary ability

Step 5b - d: do the same for WMI, PRI and PSI
- If there is undue subtest scatter, then the index cannot be interpreted as unitary construct

38
Q

step 6 and 7 of interpreting the WAIS-IV

A

Only relevant for the five factor models of interpretation

39
Q

step 8 of interpreting the WAIS-IV

A

Determining normative strengths and weaknesses

  • Involves the evaluation of the exact value of the interpretable indices
  • Review the exact value of the index. If the standard score is greater than 115, the ability is a normative strength
  • If it is less than 85, then it is a normative weakness
  • This allows the clinician to evaluate the performance on both a normative and subsequently ipsative basis
40
Q

step 9 of interpreting the WAIS-IV

A

Determine personal strengths and weaknesses

  • Compare the individual to his or her own profile of performances
  • The performances are compared to the mean performance across all of the sub-tests in the profile (or by index)
  • The determination of whether the performance represents a personal strength or weakness is based on its uncommonness, using a 10% base rate criterion
  • This allows the examiner to identify key assets and high priority concerns in the individual’s cognitive profile

Clinical vs. Statistical significance

  • Often differences may be statistically significant but may not be rare events in the general population
  • Statistical difference and clinical difference are different issues and will have different implications for interpretation of the results
  • Clinical Significance
    o The prevalence or frequency of an observed sore difference in the
    general population is also referred to as the base rate
    o Base rate provides an estimate of the rarity/commonness of the
    difference in the normal adult population
  • Best score to use (rule of thumb) is that observed in less than 10% of “normals”
  • Statistical significance
    o Is there a statistically significant difference between index scores?
    o Is the difference between the two index scores above the critical value?
41
Q

step 10 of interpreting the WAIS-IV

A

Interpret fluctuations in the person’s profile

42
Q

what is intellectual disability in DSM5

A

-neurodevelopmental disorders that begin in childhood and are characterized by intellectual difficulties as well as difficulties in conceptual, social, and practical areas of living.

following three criteria must be met:

(a) Deficits in intellectual functions, such as reasoning, problem solving, planning, abstract thinking, judgment, academic learning, and learning from experience, confirmed by both clinical assessment and individualized, standardized intelligence testing.
(b) Deficits in adaptive functioning that result in failure to meet developmental and socio- cultural standards for personal independence and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more activities of daily life, such as communication, social participation, and independent living, across multiple environments, such as home, school, work, and community.
(c) Onset of intellectual and adaptive deficits during the developmental period

43
Q

what is the disability act 2006 (VIC) section 6, subsection 3?

A
  • If a standardised measurement of intelligence is used to assess general intellectual functioning and it:
    o Indicates that the person has an intelligence not higher than 2 standard deviations below the population average, then he or she must be taken to have significant sub-average general intellectual functioning;
    o Indicates that the person has an intelligence not lower than 2 standard deviations below the population average, then he or she must be taken not to have significant sub-average general intellectual functioning
    o Is inconclusive as to whether or not the person has an intelligence higher or lower than 2 standard deviations below the population average, then the Secretary may take into account other indicators of general intellectual functioning in determining whether or not the person has significant sub- average general intellectual functioning
  • If a standardised measurement of adaptive behaviour is used to assess adaptive behaviour and it indicates a score at or below the second percentile of people of the same age and cultural group, then he or she must be taken to have significant deficits in adaptive behaviour
44
Q

Who is Ms Rosalie Ruby Red?

A

Age: 25

Family: de facto, 1 dependent child

Sex: Female

Education: Completed Yr 10 (modified)

Employment
o Briefly, 6 months as process worker

History:
o Postnatal depression diagnosed after delivery of child

Presenting problem:
o Custody dispute; competency to parent?

45
Q

what are the main sections in a psychological report?

A
  • Referral question
  • Background information (relevant history)
  • Behavioural observations
  • Evaluation procedures
  • Test results
  • Impressions and interpretations
  • Summary and recommendation
46
Q

how long should a psychological report be?

A

5-7 pages, but can vary

47
Q

what style should a psychological report be written in?

A
  • literacy: use every day language
  • clinical: focus on pathology
  • scientific: emphasise normative comparison
  • professional: short words, common usage, precise meanings
48
Q

how to present test interpretations in a psychological report

A
  • hypothesis orientated report
  • test by test results and interpretation
  • domain orientated report

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