1. PSYCHOLOGICAL EVALUATION OF HISPANIC PATIENTS : WHAT DOES TACO BELL KNOW ABOUT CRISTOBAL COLON ? John Umstead Hospital, Butner, North Carolina April 14, 2000 Antonio E. Puente Department of Psychology University of North Carolina at Wilmington Wilmington, NC 28403-3297 Tel. 910.962.3812; Fax. 910.962.7010. E-mail: puente@uncwil.edu

2. GENERAL OUTLINE OF PRESENTATION 1. Psychological Assessment of Spanish- Speakers 2. Review of practical Assessment Instruments for the Spanish-Speaker 3. Case Presentations (Staff and Puente)

3. PSYCHOLOGICAL ASSESSMENT OD SPANISH-SPEAKERS 1. Background of Confounds 2. Defining Hispanic 3. Demographics 4. Generic Difficulties 5. General Approaches 6. Interviewing 7. Psychological Testing 8. Neuropsychological Testing 9. Ethical, Training, & Public Policy Issues 10. Summary

4. BACKGROUND AND CONFOUNDS Puente’s Biases A Matter of Perspectives: The Case of Elian Gonzales Defining Ethnic-Minority: The Case of the 2000 Census

5. Puente’s Biases Cuban Neuropsychologist Training in a University of Florida state hospital Working as an academician and private practice clinician Strong ties to Russian/Cuban and Spanish psychology

6. A Matter of Perspectives: The Case of Elian Gonzales Defining orientation Whose perspective? The problem of criterion validity

7. Defining Ethnic-Minority: The case of the 2000 Census Majority Vs Minority group membership Difference between race and ethnicity

8. DEFINING HISPANIC 1. What is Hispanic? 2. Different Hispanics 3. Different Cultures and Languages 4. Intra-Ethnic Group Perceptions and Conflicts

9. 1. What is Hispanic? Language Religion Family Social Customs/Practices Educational Socio-Economic

10. 2. Different Hispanics Latino, Chicano, Hispanic, etc. WISC/WAIS Expert Panel Group Distinctions: –Cuban –Puerto Rican –Mexican –Central American –South American –Spain

11. 3. Different Cultures and Languages Language Social/behavioral Cognitive

12. 4. Intra-Ethnic group Perceptions and Conflicts Racism and Racismo; Black Vs Hispanic Educational, vocational, political & social differences Puerto Ricans Vs Cubans Vs Mexicans Spanish (Argentineans?) Vs all other Hispanics

13. DEMOGRAPHICS 1. Counting Hispanics –Green Cards –Understanding the Census 2. United States Statistics –Fastest growing ethnic-minority in the US –Tend to have more children –Current wave immigration to the US 3. North Carolina Trends –North Carolina Catholic –Migrant to blue-collar –Major areas in North Carolina

14. GENERIC DIFFICULTIES Communication “Translated” Tests “Norms” Interpretation of results Cultural adaptation & educational attainment

15. GENERAL APPROACHES 1. Translators 2. Family Involvement 3. Rapport 4. Acculturation

16. 1. Translators –Family Vs Non-Family –Professional Vs Non-Professional –Gold-Standard

17. 2. Family Involvement –Support –Contamination –Understanding Hispanic Family Dynamics

18. 3. Rapport –Time –Relationship-Building –Age –Sex/Gender –Socio-economic Differences –Culture-Specific Customs

19. 4. Acculturation –Antecedents –Processes –Consequences

20. INTERVIEW 1. Records 2. General issues 3. Specific Concerns

21. 1. Records –Availability –Comparability

22. 2. General issues –Structured Vs. Non-structured approaches –Value & significance of a cultural concept –Modes of knowledge –Modes of communication –Specific terms or concepts –Cognitive equivalence

23. 3. Specific Concerns –Family history –Work history –Religion –Social –Psychopathology

24. TESTING 1. General guidelines 2. Bias in Psychological Testing 3. The Use of Translated Tests

25. 1. General Guidelines Use most recent version of the test Administer the entire test Appreciate prior test-taking experience Test in the language selected by test-taker Evaluate within the biopsychological context Understand the importance of acculturation Interpret the results in light of empirical data Always use a variety of tests scores to arrive at conclusions

26. 2. Bias in Psychological Testing Inappropriate content Inappropriate standardization samples Examiner and language bias Inequitable social consequences Measurement of different constructs Differential predictive validity

27. 3. The Use of Translated Tests Copyright issues Language of translation Back translations Technically correct-Psychologically wrong

28. SELECTED PSYCHOLOGICAL TESTS - SPAIN 1. PERSONALITY 2. AFFECTIVE 3. DEVELOPMENTAL

29. 1. Personality –MMPI –CAQ, Cuestinario de Analisis Clinico –Cuestinario de Personalidad Pinillas Eysenk Cattell –Cuestinario Psicologica de California –Kuder –16 PF –Myers-Briggs

30. 2. Affective Inventario de Situaciones y Respuetas de Ansiedad Inventario de Actividad de Jenkins Cuestinario de Ansiedad Estado/Rasgo (adutos/ninos)

31. 3. Developmental Frostig Test Illinois de Aptitudes Psicolinguisticos

32. SELECTED NEUROPSYCHOLOGICAL TESTS - SPAIN 1. Communication 2. Memory 3. Spatial & Praxic 4. Cognition 5. Intellectual 6. Battery

33. 1. Communication Test de Vocabulario de Boston 2. Memory Benton Rivermead

34. 3. Spatial & Praxic Rey Harris Test de la Dominancia Lateral 4. Cognition Stroop

35. 5. Intellectual WAIS WISC WPPSI Bayley Otis Factor “g” 6. Battery Test de Barcelona Luria

36. SELECTED PSYCHOLOGICAL TESTS - UNITED STATES 1. PERSONALITY –MMPI –16 PF 2. AFFECTIVE –Speilberger –Beck-II 3. DEVELOPMENTAL

37. SELECTED NEUROPSYCHOLOGICAL TESTS- UNITED STATES 1. Orientation & Attention 2. Communication 3. Memory 4.Spatial & Praxic Ability 5.Cognition/Intellectual 6. Battery

38. 1. Orientation & Attention Mini-mental state Digit Symbols “A” Cancellation Test

39. 2. Communication Spanish Naming Test Boston Diagnostic Aphasia Spanish Repetition Test Reading & Writing Abilities Test Spanish Phonemic Discrimination Test Spanish Grammar Test Verbal Fluency

40. 3. Memory Verbal Serial Learning Curve Digit Span Facial memory Test

41. 4. Spatial & Praxic Abilities Draw a Cube Finger Tapping

42. 5. Cognition/Intellectual EIWA Beta III Peabody Woodcock-Munoz 6. Battery Luria

43. ETHICAL, TRAINING & PUBLIC POLICY ISSUES 1. Personnel & Pipeline Issues: Where is Our Future 2. Increase the Number of Tests and Norms Currently Available 3. Encourage Publishing Companies to Support These Issues 4. Support the Research that Provides the Foundation for Clinical Activity 5. Teach Students about Ethnic Diversity in Both Clinical and Academic Settings 6. Being “Aware” is Simply Not Enough

44. SUMMARY Defining Hispanic Changing Demographics Multi-Dimensional Problems The Question of Cognitive Equivalence Importance of Using a variety of Tests and Sources of Information What is the Criterion? Where Do We Go From Here?

45. Table 1. Ethnicity and Race According to the 1990 U.S. Census Data:Origin, Total Number, and Subgroups

46. Table 2. Several Structured Interviews Applicable to Ethnic-Minority Population