Neuropsychological Assessment Bradley J. Hallam, Ph.D. R. Psych. - - PowerPoint PPT Presentation

Neuropsychological Assessment

Bradley J. Hallam, Ph.D. R. Psych. Clinical & Forensic Neuropsychology Consultant at Medisys Corporate Health L.P.

Neuropsychological Assessment

Five parts:

– Clinical Interview – Neuropsychological Testing – Mood & personality measures – Review of medical documentation – Collateral Interviews

Neuropsychological Assessment

The neuropsychological opinion is based on analyzing and integrating hypotheses generated during testing with other clinical information about the individual’s neuropsychological status and functioning. The interpretation of test data is integrated with detailed behavioural observations, results

• f the record review and all other available

information regarding the individual.

Neuropsychological Assessment

Four-component consistency:

1. Are the data consistent within and between neuropsychological domain? 2. Is the neuropsychological profile consistent with the suspected etiologic condition? 3. Are the neuropsychological data consistent with the documented severity of injury? 4. Are the neuropsychological data consistent with the subject’s behavioural presentation?

Forensic Neuropsychology: A Scientific Approach (2005). Ed. G. J. Larrabe. Oxford University Press.

Neuropsychological Assessment

Standardized measures - standard instructions to ensure that tests are given the same way every time. Normative data - reference groups which allow you to gauge the claimant’s performance relative to demographically matched samples.

Neuropsychological Assessment

Symptom Validity - assesses for suboptimal

performance on tests that are created to be objectively quite easy, even for severely brain injured or mentally retarded individuals.

Neuropsychological Assessment

Neuropsychological Testing

• Attention
• Working Memory
• Language
• Visuospatial
• Memory
• Executive Functions
• Motor

Neuropsychological Assessment

Intellectual function - assesses cognitive functions

moderately related to achievement in academic settings and success in occupations requiring academic skills. Typically assessed by the WAIS-III which produces IQ scores and other indices.

Neuropsychological Assessment

Predicted Intellectual Function - provides an

estimate of intellectual function based on reading ability (i.e., pronunciation of irregular words). Reading scores are used because they add to prediction accuracy over and above demographic variables and because reading ability is often preserved in brain injury.

Neuropsychological Assessment

Attention - assesses capacity to direct and sustain

thoughts/actions.

Working Memory - assesses capacity for holding

and manipulating small amounts of information in mind for short periods of time (e.g., calculating the tip in your head at a restaurant).

Neuropsychological Assessment

Language - assesses expressive (i.e., ability to

communicate/express ideas verbally) and receptive (i.e., ability to comprehend verbal information) language skills.

Neuropsychological Assessment

Visuospatial - assesses the capacity to understand

and manipulate visually presented material, as well as understand spatial relationships.

Neuropsychological Assessment

Executive Functions - a complex range of abilities

that include the capacity to control and organize

• information. This domain also involves reasoning;

judgment; the ability to plan and carry out behaviour; as well as to shift efficiently from one concept to another (mental flexibility). The capacity to initiate responses when needed and to inhibit appropriate responses are also measured.

Neuropsychological Assessment

Motor - assesses fine motor speed, fine motor

dexterity, and grip strength. More focused on assessing for lateralization of brain dysfunction.

Neuropsychological Assessment

Memory - assesses the capacity to acquire learn,

recall and retain verbal (e.g., word lists and short stories) and non-verbal (e.g., faces and geometric figures) over time. These tasks are typically referred to as “short term memory”.

Should I refer the individual for a neuropsychological evaluation?

Neuropsychological Assessment

Neuropsychological Assessment

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