Assignment of Psychological Assessment

Department of Applied Psychology

Semester 5th (evening)

Submitted by : Atika Naeem (20588)

Dur- e- Nayab (20572)
Esham Shahzad(20582)
Ayyoub sabar (20571)
Submitted to : Prof.Arshad Malik
Topic : Introduction to neuropsychological Assessment
Date :March 17,23
Introduction to neuropsychological assessment :

Neuropsychological assessment is a comprehensive evaluation of cognitive, behavioral, and emotional

functioning, based on the assumption that brain function underlies all of these domains.
Neuropsychological assessments are typically conducted by licensed clinical psychologists with
specialized training in neuropsychology.

Neuropsychological assessment was traditionally carried out to assess the extent of impairment to a
particular skill and to attempt to determine the area of the brain which may have been damaged
following brain injury or neurological illness. With the advent of neuroimaging techniques, location of
space-occupying lesions can now be more accurately determined through this method, so the focus has
now moved on to the assessment of cognition and behaviour, including examining the effects of any
brain injury or neuropathological process that a person may have experienced.

The assessment process usually involves a series of standardized tests and measures, including
intellectual functioning, memory, attention, language, visuospatial abilities, executive functioning, and
emotional status. The specific tests administered depend on the individual’s presenting symptoms and
the referral question.

A core part of neuropsychological assessment is the administration of neuropsychological tests for the
formal assessment of cognitive function, though neuropsychological testing is more than the
administration and scoring of tests and screening tools. It is essential that neuropsychological
assessment also include an evaluation of the person’s mental status. This is especially true in assessment
of Alzheimer’s disease and other forms of dementia. Aspects of cognitive functioning that are assessed
typically include orientation, new-learning/memory, intelligence, language, visuoperception, and
executive function. However, clinical neuropsychological assessment is more than this and also focuses
on a person’s psychological, personal, interpersonal and wider contextual circumstances.

Assessment may be carried out for a variety of reasons, such as:

Clinical evaluation, to understand the pattern of cognitive strengths as well as any difficulties a person
may have, and to aid decision making for use in a medical or rehabilitation environment.

Scientific investigation, to examine a hypothesis about the structure and function of cognition to be
tested, or to provide information that allows experimental testing to be seen in context of a wider
cognitive profile.

Medico-legal assessment, to be used in a court of law as evidence in a legal claim or criminal

investigation.

Miller outlined three broad goals of neuropsychological assessment.

Firstly, diagnosis, to determine the nature of the underlying problem. Secondly, to understand the
nature of any brain injury or resulting cognitive problem (see neurocognitive deficit) and its impact on
the individual, as a means of devising a rehabilitation programme or offering advice as to an individual’s
ability to carry out certain tasks (for example, fitness to drive, or returning to work). And lastly,
assessments may be undertaken to measure change in functioning over time, such as to determine the
consequences of a surgical procedure or the impact of a rehabilitation programme over time.

The results of a neuropsychological assessment can be used to identify patterns of cognitive strengths
and weaknesses, diagnose cognitive disorders, monitor disease progression, and develop treatment
plans. It is often used to evaluate individuals with traumatic brain injury, stroke, dementia, and other
neurological disorders, as well as to assess individuals with developmental or learning disabilities.

Overall, neuropsychological assessment plays an important role in understanding the relationship

between brain function and behavior, and can help inform clinical decision-making and improve
outcomes for individuals with neurological and psychiatric conditions

Neuropsychological disorders:

Neuropsychological disorders are conditions that affect the brain's ability to function properly, leading
to changes in behavior, cognition, and emotion. These disorders can result from a variety of causes, such
as injury, disease, infection, or genetic factors. Some common neuropsychological disorders include:

Alzheimer's disease: A progressive neurodegenerative disorder that affects memory, thinking, and
behavior. Alzheimer’s disease is the accumulation of beta-amyloid protein and tau protein in the brain,
leading to the formation of plaques and tangles. These abnormal protein aggregates disrupt
communication between brain cells and cause brain cell death, particularly in the hippocampus and
other regions important for memory and learning.

Parkinson's disease: A chronic and progressive disorder that affects movement, balance, and
coordination. This disorder caused by the loss of dopamine-producing cells in the brain. It is
characterized by tremors, rigidity, and difficulty with balance and coordination. The substantia nigra, a
region of the brain that produces dopamine, is one of the areas affected in Parkinson’s disease.

Multiple sclerosis: An autoimmune disorder that affects the central nervous system, leading to a range
of symptoms including muscle weakness, fatigue, and cognitive impairment. MS is a chronic
autoimmune disorder that affects the central nervous system (CNS). It is caused by an abnormal
immune response in which the body’s immune system attacks the myelin sheath that surrounds and
protects nerve fibers in the brain and spinal cord.

Traumatic brain injury: A type of brain injury that results from a blow or jolt to the head, leading to
changes in cognitive function, mood, and behavior. A TBI occurs when the brain is injured by an external
force, such as a blow to the head. The symptoms of a TBI depend on the severity and location of the
injury. For example, a TBI that affects the frontal lobes of the brain can cause problems with attention,
decision-making, and emotional regulation

Autism spectrum disorder: A developmental disorder that affects social interaction, communication,
and behavior.

Attention deficit hyperactivity disorder (ADHD): A disorder characterized by inattention, hyperactivity,

and impulsivity.

Schizophrenia: A chronic mental disorder that affects a person's ability to think, feel, and behave clearly.
This is a chronic mental disorder that affects a person’s ability to think, feel, and behave clearly. The
exact cause of schizophrenia is not known, but it is thought to involve abnormalities in multiple brain
regions, including the prefrontal cortex, hippocampus, and thalamus

Depression and anxiety disorders: Conditions that affect a person's mood, leading to persistent feelings
of sadness, worry, or fear.

Epilepsy: A neurological disorder that causes seizures, which can affect a person's behavior and
consciousness.

Huntington's disease: A genetic disorder that leads to a progressive loss of cognitive, motor, and
psychiatric function.

Stroke: A stroke occurs when blood flow to a part of the brain is interrupted, causing brain cells to die.
The symptoms of a stroke depend on the location and extent of the brain damage. For example, a stroke
in the left hemisphere of the brain can cause language deficits, while a stroke in the right hemisphere
can cause visual-spatial.

Diagnosis of a neuropsychological disorder

Certain types of damage to the brain will cause behavioral and cognitive difficulties. Psychologists can
start screening for these problems by using either one of the following techniques or all of these
combined:

History taking

This includes gathering medical history of the patient and their family, presence or absence of
developmental milestones, psychosocial history, and character, severity, and progress of any history of
complaints. The psychologist can then gauge how to treat the patient and determine if there are any
historical determinants for his or her behavior.

Interviewing

Psychologists use structured interviews in order to determine what kind of neurological problem the
patient might be experiencing. There are a number of specific interviews, including the Short Portable
Mental Status Questionnaire, Neuropsychological Impairment Scale, Patient’s Assessment of Own
Functioning, and Structured Interview for the Diagnosis of Dementia.

Test-taking

Scores on standardized tests of adequate predictive validity predictor well current and/or future
problems. Standardized tests allow psychologists to compare a person’s results with other people’s
because it has the same components and is given in the same way. It is therefore representative of the
person's's behavior and cognition. The results of a standardized test are only part of the jigsaw. Further,
multidisciplinary investigations (e.g. neuroimaging, neurological) are typically needed to officially
diagnose a brain-injured patient.

Testing other areas:

Other areas are also tested when a patient goes through neuropsychological assessment. These can
include sensory perception, motor functions, attention, memory, auditory and visual processing,
language, problem solving, planning, organization, speed of processing, and many others.
Neuropsychological assessment can test many areas of cognitive and executive functioning to determine
whether a patient’s difficulty in function and behavior has a neuropsychological basis.

Tests

Neuropsychological tests are specialized tests that are designed to measure specific cognitive functions
and detect potential impairments in brain function. These tests are typically used in neuropsychological
assessments to diagnose and evaluate a variety of neurological and psychiatric conditions, such as
Alzheimer’s disease, traumatic brain injury, stroke, and attention deficit hyperactivity disorder
(ADHD).Most forms of cognition actually involve multiple cognitive functions working in unison,
however tests can be organised into broad categories based on the cognitive function which they
predominantly assess. Some tests appear under multiple headings as different versions and aspects of
tests can be used to assess different functions.

Intelligence:

Intelligence testing in a research context is relatively more straightforward than in a clinical context. In
research, intelligence is tested and results are generally as obtained, however in a clinical setting
intelligence may be impaired so estimates are required for comparison with obtained results. Premorbid
estimates can be determined through a number of methods, the most common include: comparison of
test results to expected achievement levels based on prior education and occupation and the use of
hold tests which are based on cognitive faculties which are generally good indicators of intelligence and
thought to be more resistant to cognitive damage, e.g. language.

• National Adult Reading Test (NART)

• Wechsler Adult Intelligence Scale (WAIS)
• Wechsler Intelligence Scale for Children (WISC)
• Wechsler Preschool and Primary Scale of Intelligence (WPPSI
• The Wechsler Test of Adult Reading (WTAR)

Memory:

Memory is a very broad function which includes several distinct abilities, all of which can be selectively
impaired and require individual testing. There is disagreement as to the number of memory systems,
depending on the psychological perspective taken. From a clinical perspective, a view of five distinct
types of memory, is in most cases sufficient. Semantic memory and episodic memory (collectively called
declarative memory or explicit memory); procedural memory and priming or perceptual learning
(collectively called non-declarative memory or implicit memory) all four of which are long term memory
systems; and working memory or short term memory.[4] Semantic memory is memory for facts,
episodic memory is autobiographical memory, procedural memory is memory for the performance of
skills, priming is memory facilitated by prior exposure to a stimulus and working memory is a form of
short term memory for information manipulation.

• Memory Assessment Scales (MAS)

• Rey Auditory Verbal Learning Test
• Test of Memory and Learning (TOMAL)
• Mental Attributes Profiling System
 • Wechsler Memory Scale (WMS)
• River mead Behavioral Memory Test

Language:

Language functions include speech, reading and writing, all of which can be selectively impaired.

• Boston Diagnostic Aphasia Examination

• Boston Naming Test
• Comprehensive Aphasia Test (CAT)
• Multilingual Aphasia Examination

Executive function:

Executive functions is an umbrella term for a various cognitive processes and sub-processes. The
executive functions include: problem solving, planning, organizational skills, selective attention,
inhibitory control and some aspects of short term memory.

• Behavioural Assessment of Dysexecutive Syndrome (BADS)

• Mental State Examination (MMSE) – This is a brief screening test that is used to evaluate
cognitive impairment and is commonly used to assess patients with Alzheimer’s disease and
other forms of dementia.
• Trail Making Test – This test assesses visual attention, scanning ability, and cognitive flexibility. It
involves drawing lines between numbers or letters in a specific sequence.
• Stroop Test – This test measures selective attention and cognitive control. It involves naming
the color of the ink used to print a word, while ignoring the word itself.
• The Wisconsin Card Sorting Test – This test measures cognitive flexibility and executive
functioning. It involves sorting cards based on different criteria, which can change over time.
• The Digit Span Test – This test assesses short-term memory and working memory. It involves
repeating a series of numbers in the same order or in reverse order.
• The Rey-Osterrieth Complex Figure Test – This test assesses visual perception, visuospatial
abilities, and memory. It involves copying a complex figure and then recalling it from memory.

Visuospatial

Neuropsychological tests of visuospatial function should cover the areas of visual perception, visual
construction and visual integration.Though not their only functions, these tasks are to a large degree
carried out by areas of the parietal lobe.

• Clock Test
• Hooper Visual Organisation Task (VOT)
• Rey–Osterrieth Complex

Batteries assessing multiple neuropsychological function:

There are some test batteries which combine a range of tests to provide an overview of
cognitive skills. These are usually good early tests to rule out problems in certain
functions and provide an indication of functions which may need to be tested more
specifically.

• Barcelona Neuropsychological Test (BNT)

• Cambridge Neuropsychological Test Automated Battery (CANTAB)
• Cognistat (The Neurobehavioral Cognitive Status Examination)
• Cognitive Assessment Screening Instrument (CASI)
• Cognitive Function Scanner (CFS)
• Dean–Woodcock Neuropsychological Assessment System (DWNAS)
• General Practitioner Assessment Of Cognition (GPCOG)
• Hooper Visual Organization Test
• Luria–Nebraska Neuropsychological Battery
• MicroCog
• Mini mental state examination (MMSE)
• NEPSY
• Repeatable Battery for the Assessment of Neuropsychological Status
• Short Parallel Assessments of Neuropsychological Status (SPANS)
• CDR Computerized Assessment System