Blog Archives

Demographically corrected norms for African Americans and Caucasians on the Hopkins Verbal Learning Test-Revised, Brief Visuospatial Memory Test-Revised, Stroop Color and Word Test, and Wisconsin Card Sorting Test 64-Card Version

Memory and executive functioning are two important components of clinical neuropsychological (NP) practice and research. Multiple demographic factors are known to affect performance differentially on most NP tests, but adequate normative corrections, inclusive of race/ethnicity, are not available for many widely used instruments. This study compared demographic contributions for widely used tests of verbal and visual learning and memory (Brief Visual Memory Test-Revised, Hopkins Verbal Memory Test-Revised) and executive functioning (Stroop Color and Word Test, Wisconsin Card Sorting Test-64) in groups of healthy Caucasians (n = 143) and African Americans (n = 103). Demographic factors of age, education, gender, and race/ethnicity were found to be significant factors on some indices of all four tests. The magnitude of demographic contributions (especially age) was greater for African Americans than for Caucasians on most measures. New, demographically corrected T-score formulas were calculated for each race/ethnicity. The rates of NP impairment using previously published normative standards significantly overestimated NP impairment in African Americans. Utilizing the new demographic corrections developed and presented herein, NP impairment rates were comparable between the two race/ethnicities and were unrelated to the other demographic characteristics (age, education, gender) in either race/ethnicity group. Findings support the need to consider extended demographic contributions to neuropsychological test performance in clinical and research settings.

from the Journal of Clinical and Experimental Neuropsychology


C-Speak Aphasia alternative communication program for people with severe aphasia: Importance of executive functioning and semantic knowledge

Learning how to use a computer-based communication system can be challenging for people with severe aphasia even if the system is not word-based. This study explored cognitive and linguistic factors relative to how they affected individual patients’ ability to communicate expressively using C-Speak Aphasia (CSA), an alternative communication computer program that is primarily picture-based. Ten individuals with severe non-fluent aphasia received at least six months of training with CSA. To assess carryover of training, untrained functional communication tasks (i.e., answering autobiographical questions, describing pictures, making telephone calls, describing a short video, and two writing tasks) were repeatedly probed in two conditions: (1) using CSA in addition to natural forms of communication, and (2) using only natural forms of communication, e.g., speaking, writing, gesturing, drawing. Four of the 10 participants communicated more information on selected probe tasks using CSA than they did without the computer. Response to treatment was also examined in relation to baseline measures of non-linguistic executive function skills, pictorial semantic abilities, and auditory comprehension. Only nonlinguistic executive function skills were significantly correlated with treatment response.

from Neuropsychological Rehabilitation

Executive functioning and the impact of a hearing loss: Performance-based measures and the Behavior Rating Inventory of Executive Function (BRIEF)

The impact of deafness on a child’s rated executive functioning behaviors and performance capabilities on neurological, cognitive, and achievement domains were examined in a sample of 22 deaf students (ages 5 to 18). The parent and teacher ratings on the Behavior Rating Inventory of Executive Function (BRIEF) showed significant positive correlations (p < .01) on six of the eight clinical scales. There were significant correlations between the BRIEF reports and the students' scores on the Wisconsin Card Sorting Test, the (Children's) Color Trails Test, and the Woodcock-Johnson: Writing Fluency subtest. The Wisconsin Card Sorting Test: Total Errors scale and the Writing Fluency subtest accounted for 70% variance of the parent BRIEF Global Executive Composite and 65% of the variance for the teacher report on this same composite scale. Students with genetic deafness were rated with significantly less challenges with executive functioning (p < .05) on BRIEF scales and performed significantly better on select student measures than students with other causes of deafness.

from Child Neuropsychology

Criterion Validity of the Delis-Kaplan Executive Function System (D-KEFS) Fluency Subtests After Traumatic Brain Injury

The performance of 65 patients with complicated mild–severe traumatic brain injury was evaluated on the Verbal and Design Fluency subtests of the Delis-Kaplan Executive Function System (D-KEFS), and compared with that of 65 demographically matched healthy controls. There were statistically significant group differences on Letter Fluency and Category Switching but not on any of the Design Fluency tasks. Combined, these two Verbal Fluency subtests had a classification accuracy of 65.39%, associated with a likelihood ratio of 1.87. The impact of length of coma on Letter Fluency performance but not Category Switching was mediated at least in part by processing speed. The findings suggest modest criterion validity of some of the D–KEFS Verbal Fluency subtests in the assessment of patients with complicated mild–severe traumatic brain injury. (JINS, 2011, 17, 230–237)

from the Journal of the International Neuropsychological Society

Assessing executive functioning: On the validity, reliability, and sensitivity of a click/point random number generation task in healthy adults and patients with cognitive decline

In random number generation (RNG) tasks, used to assess executive functioning, participants are asked to generate a random sequence of digits at a paced rate, either verbally or by writing. Some previous studies used an alternative format in which participants had to randomly press different response keys, assuming that this task version demands the same cognitive processes as those implied in the standard version. The present study examined the validity of this assumption. To this end, the construct validity, reliability, and sensitivity of a conceptually similar task version of the key-press task were examined. Participants had to randomly click on, or point to, the digits 1-9, laid out orderly in a 3 3 grid on a computer screen. Psychometric properties of this task were examined, based on the performance of 131 healthy participants and 80 patients with cognitive decline. The results suggest that the click/point RNG task version can be used as a reliable and valid substitute for standard task versions that use the same response set and response pacing rate as those used in the present study. This task might be a useful alternative, demanding no separate recording and recoding of responses, and being suitable for use with patients with speech or writing problems.

from the Journal of Clinical and Experimental Neuropsychology

Emotion and executive functioning: The effect of normal mood states on fluency tasks

Induced positive affect (PA) can improve verbal fluency performance, and induced negative affect (NA) can increase design fluency performance (Bartolic, Basso, Schefft, Glauser, & Titanic-Schefft, 1999). Building on this, the current study investigated associations between everyday mood states and executive functions. Participants (N = 74, mean age = 51.19 years) completed verbal and design fluency tasks and a self-report affect task. PA was associated with better verbal fluency performance, although NA was not associated with design fluency. Variations in everyday PA may be associated with cognitive performance, whereas greater shifts in NA might be needed to establish associations with executive functioning.

from the Journal of Clinical and Experimental Neurophysiology

Functional Outcome at School Age of Preterm Infants With Periventricular Hemorrhagic Infarction

The majority of surviving preterm children with periventricular hemorrhagic infarction had cerebral palsy with limited functional impairment at school age. Intelligence was within 1 SD of the norm of preterm children without lesions in 60% to 80% of the children. Verbal memory, in particular, was affected. Behavioral and executive function problems occurred slightly more than in preterm infants without lesions. The functional outcome at school age of preterm children with periventricular hemorrhagic infarction is better than previously thought.

from Pediatrics