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)
Tests administered in a
standard way
Qualitative, Non-standardized
(Russian)
Tests’ administration is not
standard, may vary
Scoring of tests’ results
Qualitative analysis of the
process and the results of the
tests’ completion
No norms exist, clinical
experience is used when
assessing tests’ performance
Qualification of hierarchical
structure of the deficit
Results are qualified according
to norms
Determination of symptoms
Advantages
of the Two Approaches to Testing
Quantitative, Standardized
(Western)
Easy to do research and
compare results using scores
and norms
No extensive clinical
experience is needed
Qualitative, Non-standardized
(Russian)
No significant information is
lost due to thorough analysis of
tests’ performance and results
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
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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
– 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
• Scoring
Report Writing
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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