TESTS TO MEASURE THE ABILITY TO ABSTRACT

Verbal Abstraction Ability

Type of task to measure abstract
1. Wechsler Similarities subtest - One traditional measure of verbal abstraction ability.
The task in this subtest is to identify how two objects (for instance, a ball and an orange)
are alike.
2. The Proverbs Test – (Proverb interpretation) type of task used to assess ability to think
abstractly. An instrument specifically designed to test abstraction and related ability,
contains a number of proverbs along with standardized administration instructions and
normative data. In one form of this test, the subject is instructed to write an explanation
of the proverb. In another form of the test, this one multiple-choice, each proverb is
followed by four choices, three of which are either common misinterpretation or concrete
responses.

include any of the various tests that require the respondent to sort objects in some logical way.
1. Object Sorting Test
2. Color-Form Sorting Test (also known as Weigl’s Test) - which require testtakers to
sort objects of different shapes and colors.
3. Another way that sorting tasks are administered is by grouping a few of the stimulus
objects together and requiring the testtaker
(a) to explain why those objects go together or
(b) to select the object that does not belong with the rest.
4. Wisconsin Card Sorting Test-64 Card Version (WCST-64; Kongs et al., 2000)
-requires the testtaker to sort a pack of 64 cards that contain different geometric figures
printed in different colors. The cards are to be sorted according to matching rules that
must be inferred and that shift as the test progresses.
 The test may be useful in screening for neurological impairment with or without
suspected injury of the frontal lobe.

TESTS OF EXECUTIVE FUNCTION

Executive function- Sorting tests measure one element of executive function, which may be
defined as organizing, planning, cognitive flexibility, and inhibition of impulses and related
activities associated with the frontal and prefrontal lobes of the brain.

Test used to measure executive function

 Tower of Hanoi – a puzzle that made its first appearance in Paris in 1883 (Rohl, 1993).
It is set up by stacking the rings on one of the pegs, beginning with the largest-diameter
ring, with no succeeding ring resting on a smaller one.
 Performance on mazes – psychologist Stanley D. Porteus became enamored with the
potential for psychological assessment of the seemingly simple task of identifying the
correct path in a maze and then tracing a line to the end point of that maze.
 This type of task was originally introduced to yield a quantitative estimate of
“prudence, forethought, mental alertness, and power of sustained attention”
(Porteus, 1942).
  Clock-drawing test (CDT) – the task in this test is for the patient to draw the face of a
clock, usually with the hands of the clock indicating a particular time (such as “ten
minutes after eleven”).
 Observed abnormalities in the patient’s drawing may be reflective of cognitive
dysfunction resulting from dementia or other neurological or psychiatric
conditions.
 Poor performance on the CDT has also been associated with visual memory
deficits (Takahashi et al., 2008), mild cognitive impairment (Babins et al., 2008),
and losses in function that ostensibly result with aging (Bozikas et al., 2008;
Hubbard et al., 2008). Parks et al. (2010) examined performance on the clock
drawing task in elderly individuals with and without Alzheimer’s disease, while
observing each group’s brain functioning by means of special imaging
equipment. It was found that performance on the clock drawing was correlated
with a specific pattern of brain activity in the healthy participants that was
different from the brain activity of those with Alzheimer’s disease.

Sample Items Used in Neuropsychological Assessment

 Trail-making item – to connect the circles in a logical way. This type of task is thought
to tap many abilities, including visuo-perceptual skills, working memory, and the ability to
switch between tasks.
 Field-of-search item – the testtaker must scan a field of various stimuli to match the
sample. This kind of item is usually timed. People with right hemisphere lesions may
exhibit deficits in visual scanning ability, and a test of field-of-search ability can be of
value in discovering such deficits.
 Confrontation naming (Boston Naming Test) – The testtaker’s task on the Boston
naming each stimulus presented.
 This seemingly simple task entails three component operations:
o a perceptual component (perceiving the visual features of the stimulus),
o a semantic component (accessing the underlying conceptual representation
or core meaning of whatever is pictured),
o and a lexical component (accessing and expressing the appropriate name).
 Picture absurdity item – the task here is to identify what is wrong or silly about the
picture. This type of item can provide insight into the testtaker’s social comprehension
and reasoning abilities.

Test of Executive Function in an Emergency (TEFE) – In the event of an emergency, it is

imperative that an individual be able to execute certain basic executive functions, such as being
able to telephone for help and provide first-responders with emergency-relevant information.
o The TEFE was designed to specifically evaluate the ability of cognitively impaired
patients to access assistance in the event of an emergency (Wiechmann et al.,
2015).

TESTS OF PERCEPTUAL, MOTOR, AND PERCEPTUAL-MOTOR FUNCTION

 Perceptual test – a general reference to any of many instruments and procedures used
to evaluate varied aspects of sensory functioning, including aspects of sight, hearing,
smell, touch, taste, and balance.
  Motor test – a general reference to any of many instruments and procedures used to
evaluate varied aspects of one’s ability and mobility including the ability to move limbs,
eyes, or other parts of the body.
 Perceptual-motor test – a general reference to any of many instruments and
procedures used to evaluate the integration or coordination of perceptual and motor
abilities.
o For example, putting together a jigsaw puzzle taps perceptual-motor ability—
more specifically, hand–eye coordination.
 The Ishihara (1964) test – used to screen for color blindness.
 Wepman Auditory Discrimination Test – a tests available for measuring deficit in
auditory functioning
o easy-to-administer test requires that the examiner read a list of 40 pairs of
monosyllabic meaningful words (such as muss/much) pronounced with lips
covered (not muffled, please) by either a screen or a hand.
o The examinee’s task is to determine whether the two words are the same or
different. It’s quite a straightforward test—provided the examiner isn’t
suffering from a speech defect, has no heavy accent, and doesn’t mutter.
 Bruininks-Oseretsky Test of Motor Proficiency – A test designed to assess gross and
fine motor skills. Designed for use with children aged 4½ to 14½, this instrument
includes subtests that assess running speed and agility, balance, strength, response
speed, and dexterity.
 Test’s box – cover could be used as an informal screening device for reading ability by
asking colleagues to pronounce the test’s name correctly.
 Purdue Pegboard Test – A test designed to measure manual dexterity. Originally
developed in the late 1940s as an aid in employee selection, the object is to insert pegs
into holes using first one hand, then the other hand, and then both hands. Each of these
three segments of the test has a time limit of 30 seconds, and the score is equal to the
number of pegs correctly placed.
 Bender Visual-Motor Gestalt Test – the test consisted of nine cards, on each of which
was printed one design. These designs could be used to assess perceptual maturation
and neurological impairment. Testtakers were shown each of the cards in turn and
instructed “Copy it as best you can.”

TESTS OF VERBAL FUNCTIONING

Verbal fluency and fluency in writing are sometimes affected by injury to the brain, and
there are tests to assess the extent of the deficit in such skills.
 Controlled Word Association Test (formerly the Verbal Associative Fluency Test) –
the examiner says a letter of the alphabet and then it is the subject’s task to say as many
words as he or she can think of that begin with that letter.
o Each of three trials employs three different letters as a stimulus and lasts one
minute; the testtaker’s final score on the test reflects the total number of correct
words produced, weighted by factors such as the gender, age, and education of
the testtaker.
 Aphasia – refers to a loss of ability to express oneself or to understand spoken or
written language because of some neurological deficit.

A number of tests have been developed to measure aspects of aphasia.

 o Reitan-Indiana Aphasia Screening Test (AST) – available in both a child and
an adult form, contains a variety of tasks such as naming common objects,
following verbal instructions, and writing familiar words.
 Factor analysis has suggested that these tasks load on two factors:
language abilities and coordination involved in writing words or drawing
objects
 Can be administered in 15 minutes or less
 may be of value in distinguishing testtakers who have brain damage from
those who do not.
 Multilingual Aphasia Examination – For testtakers of Hispanic descent, a more
culturally relevant instrument is this examination. Rey et al. (1999) found the published
norms to be comparable to their own data using a sample of Hispanic testtakers. They
also discussed specific problems encountered in neuropsychological research with
Hispanics and suggested guidelines and directions for future research.

TESTS OF MEMORY

Memory is a complex, multifaceted cognitive function that has defied simple explanation.
Contrary to the popular image of memory as a storehouse of sorts, memory is an active process
that is presumed to entail both short-term and long-term components.

 Short-term memory – Incoming information is processed in short-term memory, where

it is temporarily stored for as little as seconds or as long as a minute or two.
o The more traditional view of short-term memory is as a passive buffer in which
information is either transferred to long-term memory or dissipated (or, forgotten).
 Long-term memory – researchers have distinguished between procedural and
declarative memory.
1. Procedural memory – memory for things like driving a car, making entries on a
keyboard, or riding a bicycle. Most of us can draw on procedural memory with
little effort and concentration.
2. Declarative memory – refers to memory of factual material
2.1 Semantic memory – memory for facts
2.2 Episodic memory – memory for facts in a particular context or situation

As indicated by the one-way path from long-term memory to consciousness, information stored
in long-term memory is available for retrieval.
Figure 14–6
A Model of Memory
According to our model, memory results from information processing by the nervous system of
external (actual) sensory input, such as sights, sounds, smells, and tastes. Your stored vision of a loved
one’s face, the song you will never forget, and the smell of freshly mowed grass are examples of
memories
formed from actual sensory input. Memory of a sort may also result from what one produces internally, in
the absence of actual sensation. What one imagines, dreams, and misperceives are all examples of this
latter sort of memory. Of course, dominance of imagined or fabricated sorts of memories can become a
matter of clinical significance. The line between the sensory input channel and conscious awareness is
broken to indicate that not all sensory input automatically makes it into conscious awareness; factors
such as attention and concentration play a role in determining which stimuli actually make it into
conscious awareness. Ewan ko pero baka pede mo nalang yong sabihin? HAHHAHAHA

 Implicit memory – accessible only by indirect measures and not by conscious

recollection, has been referred to as “unconscious memory”

 California Verbal Learning Test–II (CVLT-II; Dellis et al., 2000) – The task is to repeat
a list of words that are read by the examiner. A series of trials are administered. The test
yields recall and recognition scores as well as information related to learning rate, error
types, and encoding strategies.
o Items administered in a forced-choice format may be useful in the detection of
malingering. Norms are provided for testtakers from ages 16 to 89, and there is a
short form available for use with testtakers for whom fatigue or related factors
must be taken into consideration. Also available is an alternate form of the test
for retesting purposes.
 Wechsler Memory Scale (WMS-IV) – most recent revision of a brand of memory tests
that was preceded by the WMS-III, the WMS-R, and the WMS.
o Designed for use with testtakers from ages 16 to 90
o The WMS provides index scores for Auditory Memory, Visual Memory, Visual
Working Memory, Immediate Memory, and Delayed Memory. There is some
 evidence that the WMS-IV may be a more useful measure of auditory and visual
memory than the WMS-III under certain circumstances.

Two other approaches to memory

testing
 Tactile nonsense
(nonrepresentational) figures
– approach devised by Milner
(1971), figures are employed to
measure immediate tactile (or
haptic) memory
 Seguin-Goddard Formboard –
Halstead (1947a) suggested
that the formboard could be
used to assess tactile memory if
examinees were blindfolded
during the test and a recall trial
added.
Figure 14–7
Two Tools Used in the Measurement of Tactile Memory
At left, four pieces of wire bent into “nonsense figures” can be used in a tactile test of immediate
memory. Examinees are instructed to feel one of the figures with their right or left hand (or with both
hands) and then to locate a matching figure. Shown at right is one form of the Seguin-Goddard
Formboard. Blindfolded examinees are instructed to fit each of the 10 wooden blocks into the appropriate
space in the formboard with each hand separately and then with both hands. Afterward, the examinee
may be asked to draw the formboard from memory. All responses are timed and scored for accuracy.

NEUROPSYCHOLOGICAL TEST BATTERIES

On the basis of the mental status examination, the physical examination, and the case
history data, the neuropsychologist typically administers a battery of tests for further clinical
study.

Trained neuropsychologists may administer a prepackaged fixed battery of tests or they may
choose to administer a flexible battery.

 Flexible battery
o The clinician who administers a flexible battery has not only the responsibility of
selecting the tests to be used but also the burden of integrating all the findings
from each of the individual tests—no simple task because each test may have
been normed on different populations.
o The tests administered frequently overlap with respect to some of the functions
tested, and the result is some waste in testing and scoring time.
o The total estimated administration time of the battery was about 4.5 hours, or 5.5
hours if the (optional) MMPI-2-RF was included.
 Fixed neuropsychological test batteries
o designed to comprehensively sample the patient’s neuropsychological
functioning.
o appealing to clinicians, especially clinicians who are relatively new to
neuropsychological assessment, because it tends to be less demanding in many
ways.
o a great deal of expertise and skill is required to fashion a flexible battery that will
adequately answer the referral question, a prepackaged battery represents an
alternative that is not tailor-made but is comprehensive.
o One major drawback of the prepackaged tests, however, is that the specific
disability of the patient may greatly—and adversely—influence performance on
the test.
 Halstead–Reitan Neuropsychological Battery
o Ward C. Halstead (1908–1969) was an experimental psychologist whose
interest in the study of brain–behavior correlates led him to establish a laboratory
for that purpose at the University of Chicago in 1935.
o During the course of 35 years of research, Halstead studied more than 1,100
brain-damaged persons.
o Derived a series of 27 tests designed to assess the presence or absence of
organic brain damage
 Ralph M. Reitan – founding father of neuropsychology
o A student of Halstead’s, later elaborated on his mentor’s findings.
 o In 1955, Reitan published two papers that dealt with the differential intellectual
effects of various brain lesion sites (Reitan, 1955a, 1955b).
o Reitan (1969) privately published a book entitled Manual for Administration of
Neuropsychological Test Batteries for Adults and Children—the forerunner
of the Halstead-Reitan Neuropsychological Test Battery

 Administration of the H-R

o requires a highly trained examiner conversant with the procedures for
administering the various subtests.
o The test generally requires a full workday to complete.
o Subtest scores are interpreted not only with respect to what they mean by
themselves but also in terms of their relation to scores on other subtests.
o Scoring yields a number referred to as the Halstead Impairment Index, and an
index of .5 (the cutoff point) or above is indicative of a neuropsychological
problem.
o Data on more than 10,000 patients in the standardization sample were used to
establish that cutoff point. Normative information has also been published with
respect to special populations. Cultural factors must also be considered when
administering this battery (Evans et al., 2000).
o The battery has also been used to identify behavioral deficits associated with
particular neurological lesions
 Many published and unpublished neuropsychological test batteries are designed to
probe deeply into one area of neuropsychological functioning instead of surveying for possible
behavioral deficit in a variety of areas. Test batteries exist that focus on visual, sensory,
memory, and communication problems.

 The Neurosensory Center Comprehensive Examination of Aphasia (NCCEA) – a

battery of tests that focuses on communication deficit
 Montreal Neurological Institute Battery – particularly useful to trained
neuropsychologists in locating specific kinds of lesions.
 Southern California Sensory Integration Tests – make up a battery designed to
assess sensory-integrative and motor functioning in children 4 to 9 years of age.
 Severe Impairment Battery – designed for use with severely impaired assesses who
might otherwise perform at or near the floor of existing tests.
o The battery is divided into six subscales: Attention, Orientation, Language,
Memory, Visuoperception, and Construction.
 Cognitive Behavioral Driver’s Inventory – which was specifically designed to assist in
determining whether individuals with brain damage are capable of driving a motor
vehicle

OTHER TOOLS OF NEUROPSYCHOLOGICAL ASSESSMENT

In this context, Miller et al. (2007) described a test of nonverbal reasoning designed for
use with the visually impaired and the blind. The test measures nonverbal reasoning primarily
through the haptic sense (sense of touch) using a three-dimensional matrix
Perhaps the greatest advances in the field of neuropsychological assessment have
come with the advancement of knowledge of genetics and in the application of technologically
sophisticated medical equipment for purposes of imaging neurological processes and
pathology.
 f MRI – “MRI” stands for an imaging procedure called magnetic resonance imaging
o used to create images of structures within the body
o The f MRI apparatus creates real-time moving images of internal functioning, and
is particularly useful in identifying which parts of the brain are active at various
times and during various tasks.
 X-ray – photograph’s varying shades convey information about the corresponding
density of the tissue through which the X-rays have been passed. With front, side, back,
and other X-ray views of the brain and the spinal column, the diagnosis of tumors,
lesions, infections, and other abnormalities can frequently be made.
 Cerebral angiogram – tracer element is injected into the bloodstream before the
cerebral area is X-rayed.
 CAT (computerized axial tomography) scan – superior to traditional X-rays because
the structures in the brain may be represented in a systematic series of three-
dimensional views, a feature that is extremely important in assessing conditions such as
spinal anomalies.
 PET (positron emission tomography) scan – tool of nuclear medicine particularly
useful in diagnosing biochemical lesions in the brain.
  SPECT (single photon emission computed tomography) – a technology that records
the course of a radioactive tracer fluid (iodine) and produces exceptionally clear
photographs of organs and tissues.
o SPECT technology has shown promise in evaluating conditions such as cerebral
vascular disease, Alzheimer’s disease, and seizure disorders.
 Radioisotope scan or simply brain scan – describes a procedure that also involves
the introduction of radioactive material into the brain through an injection. The cranial
surface is then scanned with a special camera to track the flow of the material.
 Electroencephalograph (EEG) – a machine that measures the electrical activity of the
brain by means of electrodes pasted to the scalp. EEG activity will vary as a function of
age, level of arousal (awake, drowsy, asleep), and other factors in addition to varying as
a function of brain abnormalities
 Electromyograph (EMG) – a machine that records electrical activity of muscles by
means of an electrode inserted directly into the muscle.
 Echoencephalograph – a machine that transforms electric energy into sound (sonic)
energy. The sonic energy (“echoes”) transversing the tissue area under study is then
converted back into electric energy and displayed as a printout.
o to determine the nature and location of certain types of lesions in the brain
 Lumbar puncture – A sample of the fluid is obtained by means of a medical procedure
In this procedure, a special needle is inserted into the widest spinal interspace after a
local anesthetic has been applied.

As medical technology and instrumentation advances, the hope is that our ability to
diagnose, prevent, and effectively treat too common and notoriously devastating disorders like
dementia will improve
 Dementia – a neurological disorder characterized by deficits in memory, judgment, ability
to concentrate, and other cognitive abilities, with associated changes in personality due
to damage to, or disease of brain neurons.
o the patient may have observed, symptoms like forgetfulness, name- or word-
finding difficulties, or some other cognition-related compromise in the execution
of daily activities.
 Neurological assessment for dementia
o administration of various tests such as the Mini-Mental-Status-Examination
o custom-designed neurologic survey
o Case history data
o Prior behavioral and medical records

Ultimately, it is the application of the knowledge, experience, judgment, and skill of the
trained clinician that will result not only in the correct diagnosis, but in the offer of the best
treatment options that are currently available to the individual so diagnosed