Psychological Testing Zara Melikyan, Ph.D. Fall 2015

Testing Using special tasks = tests to evoke certain aspects of behavior that need to be examined and assessed Neuropsychologists measure deficits in cognition and emotion because this is how brain damage is manifested behaviorally. Intact cognitions and emotions are also assessed.

Approaches to Testing Quantitative, Standardized (Western) Qualitative, Non-standardized (Russian) Tests administered in a standard way Tests’ administration is not standard, may vary Scoring of tests’ results Qualitative analysis of the process and the results of the tests’ completion Results are qualified according to norms No norms exist, clinical experience is used when assessing tests’ performance Determination of symptoms Qualification of hierarchical structure of the deficit

Advantages of the Two Approaches to Testing Quantitative, Standardized (Western) Qualitative, Non-standardized (Russian) Easy to do research and compare results using scores and norms No significant information is lost due to thorough analysis of tests’ performance and results No extensive clinical experience is needed

Standards for Deficit Measurement Normative – from matching population May vary with age, education, gender, general mental ability Individual – derived from individual past or present characteristics

Deficit Measurement Direct – using normal comparison standards Indirect – using estimate of previous performance Estimating premorbid ability using tests of verbal ability and knowledge NART Wechsler scale score for estimating premorbid ability Demographic data formulas for estimating premorbid ability

Neuropsychological Examination: Procedures Purposes of examination Diagnostic questions: etiology and prognosis of symptoms Descriptive questions How the problem is expressed Hypothesis guide the examination

Conduct of the Examination Examiner’s background Patient’s background Social history Present life circumstances Medical history and current medical status Circumstances surrounding examination

Procedures Referral When to examine Sudden onset of symptoms: e.g., trauma, stroke Following the post-acute stage Long-term planning Evolving conditions: degeneration, tumors

Initial Planning Record review Interview With patient With proxies

Initial Planning Preparatory interview Purpose of examination Nature of examination Use of examination information Confidentiality Feedback to patient Explanation of test procedures How patient feels about testing

Initial Planning Observation Tests’ selection Goals of examination Validity and reliability of tests Sensitivity and specificity of tests Parallel forms Time and costs Non-standardized assessment techniques

Testing Batteries Fixed Flexible Mixed Domains tested Executive functions, attention Memory: verbal, visual Motor functions Visual, visual-spatial functions Speech and language Intellectual functioning Academic achievement Emotional functioning Personality assessment

Tests’ Selection Purpose of the testing Setting of testing Research Clinical: assessment, screening, rehabilitation Setting of testing Characteristics of population/condition Limitations Time Financial Fatigue

Testing Issues Order of tests’ presentation Testing the limits Using technicians Examining special populations with sensory/motor deficits Maximizing patient’s performance level

Scoring, Reporting Scores, Interpreting Data

Report Writing Demographic information Presentation Complaints (from patient, from proxy) Current functioning Social history Health history Testing observations Testing results Interpretation of testing results Conclusion Diagnosis Recommendations