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Chapter 9: Intellectual and Neuropsychological Assessment (230)…
Chapter 9: Intellectual and Neuropsychological Assessment (230)
Intelligence Testing
Classic Theories of Intelligence
Intelligence: clinical psychologists have never reached a consensus regarding the definition of intelligence
Experts have discussed speed of mental processing, sensory capacity, abstract thinking, imagination, adaptability, capacity to learn through experience, memory, reasoning and inhibition as facets of intelligence
Charles Spearman
intelligence is a singular characteristic
"g" (general intelligence): represented a person's global, overall intellectual ability
measured many different, specific capabilities of his participants, including academic abilities and sensory-discrimination tasks
"s" (specific abilities): exist but play a relatively minor role in intelligence
Luis Thurstone
opponent of Spearman's singular theory of intelligence
intelligence should not be understood as a single, unified ability but as numerous distinct abilities that have little relationship to one another
pioneer of multiple factor analysis: enables one to identify underlying factors in a large data set
hierarchical model of intelligence: specific abilities existed and were important, but they were all at least somewhat related to one another and to a global, overall, general intelligence
measures a client's intellectual abilities
More Contemporary Theories of Intelligence
James Cattell
fluid intelligence: the ability to reason when faced with novel problems
crystallized intelligence: the body of knowledge one has accumulated as a result of life experiences
John Carroll
three-stratum theory of intelligence: intelligence operates at three levels- "g" at the top, 8 broad factors beneath "g" and over 60 highly specific abilities beneath the broad factors
Wechsler Intelligence Tests
David Weschler
Wechsler Adult Intelligence Scale- Fourth Edition (WAIS-IV)
Wechsler Intelligence Scale for Children- Fifth Edition (WISC-V)
Wechsler Preschool and Primary Scale of Intelligence- Fourth Edition (WPPSI-IV)
yield a single full-scale intelligence score, 4 or 5 index scores and a dozen specific subset scores; Wechsler tests employ a hierarchical model of intelligence
administered one-on-one and face-to-face; structured interpersonal interaction requiring extensive training, typically received during graduate programs in clinical psychology
each subtest is brief and consists of items that increase in difficulty as the subtest progresses; examinees continue until they fail a predetermined number of consecutive items
each test has a small number of unique subtests, most subtests appear in all three tests as either core of supplemental subtests
originally designed with 2 categories (verbal and performance); factor analyses indicate that the WAIS has 4 factors and WISC and WPPSI have 5 factors
Verbal Comprehension Index: a measure of verbal concept formation and verbal reasoning
Perceptual Reasoning Index: a measure of fluid reasoning, spatial processing, and visual-motor integration
Working Memory Index: a measure of the capacity to store, transform and recall incoming information and data in short-term memory
Processing Speed Index: a measure of the ability to process simple or rote information rapidly and accurately
large (2000 people), carefully collected (reflect US census data) sets of normative data
full-scale and index scores generated by the Wechsler tests are IQ scores- examinees; raw scores are compared with age-based expectations
mean score of 100 with standard deviation of 15; each subtest= average score of 10 with standard deviation of 3
assessors consider the full-scale IQ score, interpret each index score in relation to the others and then the pattern of subtest scores, finally note more detailed aspects of the testing, such as observable patterns of behavior that may have contributed to scores or inconsistent performance within a single subtest; allow assessor to grasp the "big picture" of the intellectual profile
used for a wide range of clinical applications- IDD, developmental delays, giftedness, educational and vocational planning, school placement and qualification
Strengths: impressive reliability and validity; feature comprehensive and recent normative data; cover an extremely wide age range; provide full-scale, index and subtest scores that have great clinical utility; familiar to most clinical psychologists
Limitations: culturally loaded or biased; connection between the tests and day-to-day life (ecological validity) may be limited; scoring can be complex or subjective on some subtests
Stanford-Binet Intelligence Scales-Fifth Edition
dominated the field in the early 1900s until Wechsler's tests have taken a leading role in recent decades
similar to Wechsler tests: administered face-to-face and one-on-one; employs a hierchical model of intelligence and therefore yelds a singlar measure of full-scale IQ, 5-factor scores, and many more specific subtest scores; mean of 100 and standard deviation of 15; psychometric data (reliability and validity) are similarly strong
Difference from Wechsler tests: covers entire life span as single test; normative sample matches US census but includes normative data from individuals with specific relevant diagnoses; subtests include extensions at the low and high ends (greater number of very easy and very difficult items) to more accurately assess people at extremes; each factor is measured both verbally and nonverbally
Fluid Reasoning: the ability to solve novel problems
Knowledge: general information accumulated over a time via personal experiences, including education, home, and environment
Quantitative Reasoning: the ability to solve numerical problems
Visual-Spatial Processing: the ability to analyze visually presented information, including relationships between objects, spatial orientation, assembling pieces to make a whole, and detecting visual patterns
Working Memory: the ability to hold and transform information in short-term memory
Additional Tests of Intelligence: Addressing Cultural Fairness
tests feature subtests that place individuals from minority cultural groups at a disadvantage
Universal Nonverbal Intelligence test-2 (UNIT-2): language-free test of intelligence; administered one-on-one and face-to-face; instructions are presented via 8 specific hand gestures taught in the test manual and demonstrated in an accompanying video; all responses of the examinee consist of either pointing with fingers or minor manipulation of objects with hands or fingers
appropriate for clients 5-21; normed on 1800 people who match US census data; generally acceptable reliability and validity
memory tier subtests
object memory: the examinee views a visual assortment of common objects for 5 seconds and then views a larger array and identifies the objects from the first array
spatial memory: the examinee recalls the placement of colored chips on a three-by-three or four-by-four grid
symbolic memory: the examinee recalls and recreates sequences of visually presented symbols
reasoning tier subtests
cube design: the examinee arranges colored blocks in a specific three-dimensional design
mazes: the examinee completes traditional maze puzzles
analogic reasoning: the examinee solves analogy problems that are presented visually rather than verbally
shortcomings: asses a limited range of abilities than more traditional IQ tests; appropriate only for young clients; limited psychometric data; not as well-established as other IQ tests
Achievement Testing
measure what a client has accomplished with intellectual abilities
Achievement vs Intelligence
intelligence refers to a person's cognitive capacity- what a person can accomplish intellectually
achievement: what a person has accomplished
prior to DSM-5, the comparison of intelligence and achievement was a key factor in determining learning disabilities; now the primary comparison is between the person's achievement and expected levels of achievement for people of the same age
psychological reports: the formal means by which psychologists communicate findings of assessments to others
Wechsler Individual Achievement Test- Third Edition: comprehensive achievement test for clients aged 4-50 years old; administered face-to-face and one-on-one & 4 broad areas each with 4 subtests
Math
Numerical Operations: written math problems
Math Problem Solving: word problems, numerical patterns, statistics and probability questions
Reading
Word Reading: reading isolated words
Pseudoword Decoding: using phonetic skills to sound out nonsense words, such as plore or tharch
Reading Comprehension: reading sentences or passages and answering questions about their content
Written Language
Spelling: increasingly difficult words
Sentence Composition, Essay Composition: constructing sentences, paragraphs, or essays as instructed
Oral Language
listening comprehension: paying attention to orally presented information and answering questions about it
Oral Expression: using speech to repeat spoken material, create stories about presented pictures, provide directions, etc.
mean of 100, SD of 15; age and grade equivalencies for each subtest; standardized on 3000 people who match US census data; linked to the Wechsler IQ tests because many people in the standardization samples were the same; reliability and validity are strong
Neuropsychological Testing
focuses on issues of cognitive or brain dysfunction, including the effects of brain injuries and illnesses- measures cognitive functioning or impairment of the brain and its specific components or structures
specialized area of assessment, typically practiced by clinical psychologists whose training includes extra training in neuropsychology
CT, MRI and PET scans can indicate that part of the brain looks abnormal, but neuropsychological tests show how that part of the brain is actually functioning
useful for targeted assessment of problems that might result from a head injury, prolonged alcohol or drug use or degenerative brain illness; can be used to make a prognosis for improvement, plan rehabilitation, determine eligibility for accommodations at school or work and establish a baseline of neuropsychological abilities to be used as a comparison at a later date
Full Neuropsychological Batteries
Halstead-Reitan Neuropsychological Battery (HRB): battery of eight standardized neuropsychological tests; suitable for clients aged 15 years or older (alternate versions available for younger clients; administered only as a whole battery; thorough/lengthy
Primary Purpose: identify people with brain damage and, to the extent possible, provide detailed information or hypotheses about any brain damage identified, including specific cognitive impairments or physiological regions of the brain that may be deficient; findings can be in diagnosis and treatment of problems related to brain malfunction
8 tests- some involve sight, hearing, touch, motor skills and pencil-and-paper tasks
norm-referenced; interpretation of results can include detailed inferences about specific neuropsychological pathologies and the localization of problems in cognitive functioning
has been evaluated more than any other comprehensive neuropsychological test; reliable and valid; comprehensive & clinically useful
drawbacks: length and expense, inflexibility & limited overlap with function
Luria-Nebraska Neuropsychological Battery (LNNB): wide-ranging test of neuropsychological functioning, consisting of 12 scales with a similar range to that of the HRB
emphasizes both quantitative and qualitative data; relies on comments (observations about comprehension, missing items, unusual behaviors, etc) from the examiner more than the HRB
slightly briefer than HRB; is reliable and valid
Brief Neuropsychological Measures
Bender Visual-Motor Gestalt Test-Second Edition (Bender-Gestalt-II): most commonly used neuropsychological screen among clinical psychologists; originally published in 1938
straightforward copying task: client is asked to copy each geometric design presented to them as accurately as possible
measures visuoconstructive abilities (visual-spatial/perceptual-motor)
current edition offers memory tasks and additional stimuli
only takes 6 minutes to administer & is appropriate for clients above 3 years old; good for a quick check of neuropsychological problems; results cannot specify locations of brain damage but poor performance can suggest brain damage & alert psychologist about the general presence of neuropsychological problems so more thorough testing can be conducted
poor performance is indicated by a variety of errors that clients make in copying the figures
Rey-Osterrieth Complex Figure Test: brief pencil-and-paper drawing task; drawing one more complex figure; different colored pencils to trace client's approach & includes a memory component
Repeatable Battery for The Assessment of Neuropsychological Status (RBANS): focuses on a broader range of abilities than the Bender-Gestalt or Ray-Osterrieth; tests visuomotor abilities, verbal skills, attention and visual memory; takes 20-30 minutes; 12 subtests in 5 categories; yields a total score and individual scores for the subtests
Wechsler Memory Scale-Fourth Edition (WMS-IV): frequently utilized for neuropsychological purposes; memory test used to assess individuals 16-90 years old who are suspected of having memory problems due to brain injury, dementia, substance abuse or other factors; assess both visual and auditory memory across 7 subtests; assess immediate and delayed recall