Antonio E. Puente, Ph.D.
University of North Carolina Wilmington
University of Georgia
04.05.10
Lezak’s Neuropsychological Assessment
 English based Clinical neuropsychology has
generalized Western culture concepts across
different cultures, especially Spanish speakers
residing in the US
 Today, despite an increasing interest in the
effects of culture on cognitive functions,
understanding of the cultural impact on
neuropsychology is still limited (Ardila,1996).

 Time
is something primary and crucial in
daily routine for Western societies. In
contrasts, time is not as important in
Hispanic countries.
 As a result, individuals not familiarized with
the Westernized concept of time might have
inaccurate scores in timed testing.
(Ardila & Moreno, 2001; Puente & Agranovich, 2004, Puente &Salazar, 1998
Eight is a two syllable word in Spanish (Ocho)
but one syllable in English.
 The FAS Fluency Test is often used to
determine verbal fluency, however, Spanish
the letters F, A, S, are not used with similar
frequency
 Spanish speakers use different names for bus
in different countries (bus, micro, microbus,
guagua).

(Puente & Puente, 2009)
Hispanics are the largest ethnic minority in
the U.S. and the fastest in growth (without
including undocumented immigrants)
 Hispanics make about 15% of the U.S.
population and are expected to become the
largest group by 2050-60.
 Population:
U.S.
304,059,728
Hispanics:
46,822,476

Source: U.S. Census Bureau, 2008 American Community Survey, & PEW Research
Center.
6
7
8
9
HISPANIC POPULATION BY STATE: 2008
----------------------------------------------------------------------------------------------State
Hispanic
% Hispanic
Population
Population
Within State
__________________________________________________________
1- California
13,434,896
36.6%
2- Texas
8,815,582
36.2%
3- Florida
3,846,267
21.0%
4- New York
3,232,360
16.6%
5- Arizona
1,964,625
30.2%
____________________________________________________________
Source: U.S. Census Bureau, 2008 American Community Survey, & PEW Research
Center
State
Growth
South Carolina
88.1%
Minnesota
86.4%
Nebraska
84.5%
Arkansas
82.1%
North Carolina
86.4%
Georgia
79.7%
Kentucky
76.3%
Iowa
71.6%
Nevada
70.9%
Source: U.S. Census Bureau, 2008 American Community Survey, & PEW Research
Center
Source: U.S. Census Bureau, 2008 American Community Survey, & PEW Research
Center

By Term
• Chicano/a? Hispanic? Latino/a?

By Race
• Caucasian? Negroid? Mixed (Mulatto)?

By Behavior
•
•
•
•
Language
Family
Heritage
Behaviors
Language- Spanish
 Religion- Catholic or Christian
 Family
 Children
 Friends
 Cooperation
 Personalismo
 Modesty
 Respect & Formality
 Hospitality
 Enjoyment of Living


Typical Educational Background
• Often Limited
• Usually in Spanish
• Many are illiterate in Spanish and English

What it Means to be “Educated”
• The difference between schooling and “education”
• The value of “educado”
• The limits of “education”
College Graduate :
 Some College:
 High School Graduate:
 9th to 12th Grade:
 Less than 9th grade:

12.9%
21.9%
26.0%
15.7%
23.5%
Source: U.S. Census Bureau, 2008 American Community Survey
Family Defined
 Types of Families

•
•
•
•

Nuclear
Extended
Divided
Double
Types of Family Members
• Biological
• Non-biological
Predominantly Catholic (70%)*
 Importance of Religion and Related Social
Support
 Always Hoping for a “Milagro”
 Church and Related Services in Spanish
 Religion as a Code of Conduct

* Pew Hispanic Center
Educational
 Medical
 Legal

◦ Tax ID Numbers
◦ Social Security Numbers
◦ Driver’s Licenses
Aliases
 11 million undocumented*

*Pew Hispanic Center, 2009
Variation of Spanish (e.g., Proverbs)
 Spanish as a Second Language (i.e., Mayan)
 Limits and Perils of Translations
 Importance of Non-Verbal Communication
 Difficulties With Learning English




Less than 20,000
44.3%
20,000 to 40,000
41.2%
50,000 or more
14.5%
• Foreign born
• Native born
• Foreign born
• Native born
• Foreign born
• Native born
46.5%
41.9%
42.6%
39.6%
10.9%
18.5%
Source: U.S. Census Bureau, 2008 American Community Survey
Why do Spanish Speakers do More Poorly on Most
Cognitive & Neuropsychological Measures?
Can You Actually Translate Tests from English into
Spanish?
What about Norms? Local? Regional? Universal?
Will There be Test Publishers Interested in These
Endeavors?
Will There Be Sufficient Personnel To Pursue These
Questions?
What Can Do We Actually Know?
 Total
number of articles in PsychInfo on
Psychological Testing:

29,186 (only 239 involve Psychological
Testing & Hispanics)
23
There are relatively few tests available in Spanish
There are relatively fewer tests being used by HNS
members that responded to this survey
There appears to be approximately 25-40 tests that
are used frequently and a larger number of tests that
are used highly infrequently.
Most, if not all, of the tests available in Spanish do
not meet the criteria for the Standards for
Educational and Psychological Testing (1999).
 The
total number of tests available in Spanish is very
small and most do not meet current standards for
psychological tests according the Standards for
Educational and Psychological Testing.
 Due to copyright, varieties of economic concerns and
cultural variations, this is a very, very difficult task
Culture affects neuropsychological
assessments
 Difficult to Define Hispanic
 Changing Demographics
 Difficult, Slow, Economically Challenging
 The Question of Cognitive and Emotional
Equivalence and Construct Irrelevance
 Where Do We Go From Here?

Antonio E. Puente, Ph.D.
Department of Psychology
University of North Carolina Wilmington
Wilmington, North Carolina 28403
puente@uncw.edu
910.962.3812