L8: Neuropsychological Assessment

Neuropsychology

Relationship between brain functioning and behavior. To determine possible brain damages

Neuropsychological Testing

How well your brain works. Combination of IQ & Personality tests for a range of mental functions

• Reading

• Language use

• Attention

• Learning

• Processing Speed

• Reasoning

• Remembering

• Problem-Solving

• Mood

• Behavior

Range of mental functions determined in Neuropsychological Testing

Behavioral Neurology

Subspecialty within specialty of neurology that also focuses in brain-behavior relationships.

Brain Damage

General reference to any physical or functional impairment in the CNS

Acalculia

Deficit in arithmetic calculations

Agnosia

Deficit in recognizing sensory stimuli

Agraphia

Deficit in writing abilities

Akinesia

Deficit in motor movements

Alexia

Inability to read

Amnesia

Loss of memory

Amusia

Deficit in ability to produce/appreciate music

Anopia

Deficit in sight

Aphasia

Deficit in communication due to impaired speech/writing ability

Apraxia

Voluntary movement disorder in absence of paralysis

Ataxia

Deficit in motor ability and muscular coordination

• General Intellect

• Reading/Reading Comprehension

• Ability to use language and understand what others say

• Attention/Concentration

• Processing Speed

• Learning & Memory

• Reasoning

• Executive Functions

• Ability to understand the rs between objects and space

• Mood & personality

• Fine & motor skills

Neuropsychological Evaluation

Draw inferences

Objective of neuropsychological evaluation is to ____ about structural and functional characteristics of a person’s brain by evaluating an individual’s behavior in defined stimulus-response situations

Hard sign

Big movements; Definite neurological deficits.

Ex: Block puzzle, block design task

Soft sign

Limited movements, soft movements. Merely suggestive of neurological deficits.

Ex: pagtuturo using a finger

1. History Taking; Case History

2. Interview

3. Neuropsychological MSE

Elements of Neuropsychological Evaluation

1. Proverbs Test

2. Object Sorting Test

3. Color-Form Sorting Test

4. Wisconsin Card Sorting Test-64 card version

Test to evaluate Abstract Thinking

Pattern Analysis

Look beyond performance on individual tests to study of the pattern of test scores. (If nakikita yung pattern na lahat mababa, possible na may brain damage)

Inability or lessened ability to think abstractly

Common symptom associated with neuropsychological deficit

1. Tower of Hanoi

2. Mazes

3. Clock-Drawing Test

Measures of Executive Functions

Perceptual Test

General reference to any of many instruments procedures used to evaluate varied aspects of sensory functioning

Motor Test

Used to evaluate varied aspects of one’s ability and mobility

Perceptual-Motor Test

Used to evaluate the integration/coordination of perceptual & motor abilities

1. Bender Visual-Motor Gestalt Test (BVMGT)

2. Halstead-Reitan Neuropsychological Battery (HRNB)

3. Luria Nebraska Neurospychological Battery (LNNB)

4. California Verbal Learning Test (CVLT)

Perceptual-Motor Tests:

Bender Visual-Motor Gestalt Test (BVMGT)

Purpose: Evaluate visual-motor functioning, visual-perceptual skills, neurological impairment, emotional disturbances

Target: Brain Damage & Neurological Deficits

Age: 3-85 years old

Time: No time limit

Administration:

• Consists of 9 figures (3×5 cards) wherein examiner presents each figure and ask examinee to copy them onto a single piece of blank paper.

• Papakita, tatanggalin, ipapadraw. If nagawa madraw yung figure then possible na walang brain functioning (not necessary copy na copy everything—as long as magawa yung pattern or yung itsura ng figure na pinakita), just intellectual functioning problems.

Fixed Battery

Group of test pre-modified before the assessment. 1 Personality, 1 IQ, 1 Neurpsych test. Similar to Test Battery

Flexible Battery

Assortment of instruments hand-picked for some purpose relevant to the unique aspects of the patient and presenting problem. Clien-centered assessment; depends on purpose & reason; administering test related to referral problem (kung ano napansin all throughout)

Halstead-Reitan Neuropsychological Battery (HRNB)

Purpose: Dysfunction in 2 or more brain hemispheres.

Target: Language, attention, motor dexterity, sensor-motor integration, abstract thinking, memory

Age: 15-older

• Language

• Attention

• Motor Dexterity

• Sensory-motor Integration

• Abstract Thinking

• Memory

Halstead-Reitan Neuropsychological Battery purports to measure the following elements:

1. Category test

2. Factual performance test

3. Seashore Rhythm Test

4. Speech Sounds Perception Test

5. Finger Tapping Test

Halstead-Reitan Neuropsychological Battery Five Core Subtests

1. Trail Making Test

2. Reitan Indiana Aphasia Screening Test

3. Reitan-Klove Sensory Perceptual Examination

4. Grip Strength Test

5. Lateral Dominance Examination

Halstead-Reitan Neuropsychological Battery Five Optional Subtests

Luria Nebraska Neuropsychological Battery

Purpose: Brain as functional system

Target: General Knowledge

Items: 269

Age: 8-12 Years Old

Time limit: 2-3 hours

1. Motor functions

2. Rhythm

3. Tactile

4. Visual

5. Receptive Speech

6. Expressive Speech

7. Reasoning

8. Arithmetic

9. Skills

10. Memory

11. Intellectual Processes

Subsections of Luria Nebraska Neuropsychological Battery

1. Halstead-Reitan Neuropsychological Battery

2. Luria Nebraska Neuropsychological Battery

2 Well-known fixed battery automatically given:

California Verbal Learning Test (CVLT)

Purpose: Determines how errors are made in tasks

Target: To compare alzheimers, korsakoff, huntingtons

Tool: Paper and pen or Computer

1. Peabody Picture Vocabulary Test

2. Leiter Intellectual Performance Scale

3. Porteus Maze Test

4. Columbia Mental Maturity Scales (CMMS)

5. Kaufman Assessment Battery for Children

Other neuropsychological tests:

Peabody Verbal Learning Test

• 2-90 years old

• not used with people who are deaf

• measures intelligence through hearing

• provided 204 plates and pictures

• not a substitute to WISC or SB-5

Leiter Intellectual Performance Scale

• 3-75 years old

• measures performance and verbal aspect

• vocabulary and performance

• general knowledge and task

Porteus Maze Test

• supplementary to WAIS, non-verbal performance

• may starting point then lalabas doon

• pen-and-paper test

Columbia Mental Maturity Scale (CMMS)

• alternative to WISC and SB-5 for children with cerebral palsy, intellectual disability, brain damage, IQ, and neuro

Kaufman Assessment Battery for Children (KABC-III)

• young children 7-18 years old

• measures brain functioning (overall)