APPLICATION OF NEUROPSYCHOLOGICAL

ASSESSMENTS ON VARIOUS AREAS OF - Shreyasi Vashishtha

Assistant Professor, SGT
LIFE, ISSUES, CHALLENGES AND Unniversity, Gurgaon

PROSPECTS IN INDIAN CONTEXT

OUTLINE OF THE PRESENTATION
Brief Introduction of neuropsychological assessment
 Application
 Current Tests Available
 Issues
 Challenges
 Future Directions
• . NEUROPSYCHOLOGICAL ASSESSMENT

Neuropsychological assessment refers to the measurement of cognitive function and

process with the aim to establish whether cognitive impairment or dysfunction is present
in individuals, typically in patients with brain disease, psychiatric disorder or
information processing complaints.

Cognitive process that are being investigated involves thinking, planning, moving,
talking, remembering, feeling and sensing.

Deficits in any of these function can greatly impact one's life.

NEUROPSYCHOLOGICAL EVALUATION CAN

 Provide evidence that a brain injury has caused changes

 Give an idea of what the person can or cannot be expected to do
 Help identify what a person needs to be successful, including adaptations and compensation
strategies, supervision, learning style, or teaching strategies
 Help people understand how the injury has changed them
Predict the externalization behavioral problems
 Help others see how people with the brain injury see themselves
 Help plan rehabilitation or other treatment
 Aid in educational planning and vocational planning
 Document changes for legal purposes
Orientation
Items :Orientation to tme, place, person
Test : Glassgow Coma Scale, Galveston Orientation and Amnesia
Test (GOAT)
Sensation and Perception
Items: Visual Field examination, Discrimination of similar auditory, verbal simuli
Test : Halstead–Reitan Neuropsychological Battery includes a sensory-perceptual
examination that tests for finger agnosia, skin writing recognition, and sensory
extinction in the tactile, auditory, and visual modalities

Attention and Concentration

Items: Counting backwards, Serial Subtraction, Digit Span
Test : Digit-Symbol, d2 test for attention, Trail Making
Motor Skills
Items : Cortically mediated responses: 'Raise your arm'; Clap; Touch nose etc.
Test : Finger Tapping, Grip Strength Test

Verbal Functions
Items: Vocabulary Knowledge and recognition of concept and objects [happiness]
Test : Control Oral Word association test (COWA); Token test ('Touch red circle')

Visuospatial Organization
Items: Clock drawing, Motor free constructional task ('which of these lines make
Facial Recognition; Visual Sequencing figure on top')
Test: Bender- Gestalt test, Complex Figure Test
Memory
Items: Immediate and delayed Memory tasks (Verbal & Non-verbal)
Free recall and recognition tasks;
Test : Wechsler Memory Scale, PGI-MS

Judgement/ Problem Solving

Items: Common Proverbs, Mental Arithmetic; Solution to common everyday
problems (Rain, Miss bus)
Test : Picture Absurdity Test, Wisconsin Card Sorting Test, Tower of London
COMPREHENSIVE BATTERIES APPROACH
1. AIIMS Neuropsychological Battery
2. NIMHANS neuropsychological battery
3. PGI- BBD
3. Luria Nebraska Neuropsychological Battery
4. Halstead–Reitan Neuropsychological Battery

Basic Advantage
- All neuropsychological parameters
-Objective Pattern of Scores
- Teaching Assessment and Intervention
Disadvantages
- Time
- Fatigue or Low Motivation
- Inflexible Approach in testing : Fail to recognize alternation in the standardized
content are more valuable in determining specific deficit
ISSUES AND CHALLENGES
-Test are usually translated and adapted from western ones, leading to issues like
cross- cultural validity
 Adaptation of non-verbal tests to accommodate cultural difference is equally important (Tollman and
Msengana 1990; T. M. C. Lee, Cheung, Chan, & Chan, 2000)
 Early experience with language may exert subtle effects on the performance of even nonverbal tests.

- Suitability of the test given educational background, eg: Dementia rating scales for
elderly. (Chan, Cheung, D. Shum 2003)

-Most of the tests described in the studies were paper-and-pencil tests, but a small number
involved computerized testing
Chan, Cheung, D. Shum (2003), reviewed following test on Proper procedure, validity,
normative data (greater than 50), Translation and cross-checking of translation (e.g.,
back translation) and Cross-cultural comparison (by empirical studies or by comparing
local findings with Western findings) had been conducted to demonstrate the
applicability of the test in the local population. Result show that none met the criteria.
FUTURE DIRECTIONS
- More developing area like forensic neuropsychological assessments that aid
in detection of Malingering needs to develop
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