Neuropsychological Assessment

D. Anne Winiarski, M.A.1 and Harry A. Whitaker, Ph.D.

1
Emory University
Corresponding author:
D. Anne Winiarski, M.A., Department of Psychology, Emory University, 36 Eagle Row,
Atlanta GA, 30322. Email: [email protected]

This entry examines the applications of neuropsychological assessment, with particular

emphasis on some of the most common standardized batteries available for testing a wide
array of functions. Some of the most widely used and empirically validated cognitive,
behavioral, academic, and personality measures are discussed. The entry concludes with a
brief overview of summarizing findings from a clinical evaluation in a comprehensive
neuropsychological report.

Key words: Neuropsychological evaluation, standardized assessment,

psychological battery, cognitive functions, psychological assessment

Neuropsychological assessment provides psychologists with a powerful tool for

understanding the cognitive, academic, and behavioral manifestations of underlying brain

functioning. Clinical neuropsychologists administer assessments to clients in order to

determine whether they are suffering from conditions that may not be readily detectable

using brain-imaging technology, such as a learning disability or Attention-Deficit

Hyperactivity Disorder. Neuropsychological evaluations also enable psychologists to

determine what kinds of services, or accommodations, may be most beneficial to the

client. This entry briefly examines some of the applications of neuropsychological

assessment across a variety of contexts, examines widely used reliable and valid

measures of cognitive functioning, academic functioning, behavior, and personality, and

concludes with a suggested approach for summarizing assessment findings in the form of

a comprehensive report, as well as a comment on the future of standardized

neuropsychological assessment in an era of rapidly developing technological

advancements. Some of the most widely used assessments are described below, but it

should be noted that the selected assessments discussed in this chapter are not an

exhaustive list, nor was it possible to expound on each assessment’s psychometric

properties at length. The interested reader is encouraged to review the manuals associated

with each assessment, and cited within the text. Furthermore, neuropsychological

assessments related to speech deficits are not covered in this chapter, and the interested

reader is encouraged to reference (Treatment and Remediation of Language Disorders;

Language and Speech Testing).

Goals of Neuropsychological Assessment

Neuropsychological assessment has many practical applications; six important

ones stand out: diagnosis; patient care; treatment planning and remediation; treatment

evaluation; research; and forensic applications (Lezak, Howieson, & Loring, 2004).

The first goal of neuropsychology, diagnosis, may seem quite obvious. Although

superior medical techniques exist for identifying sites of brain damage, it is often a

neuropsychological evaluation that illuminates the extent of deficits related to that injury,

and how they manifest behaviorally and cognitively. Moreover, sensitive diagnostic

neuroimaging techniques do not yet exits for identifying certain organic brain disorders

(e.g., Alzheimer’s, CITE), further necessitating the utilization of neuropsychological

assessment.

Neuropsychological testing also provides clinicians and treatment providers with

pertinent information relating to a patient’s current level of functioning. For example, an

assessment can provide insight into whether a patient is able to care for him or herself or

whether the patient is capable of performing successfully academically or professionally.

Relatedly, information concerning treatment planning can typically be gleaned from

“accommodations” provided in a neuropsychological report. In some cases,

neuropsychological assessment may be useful in evaluating pharmacological or medical

treatments, such as when patients are prescribed medication or undergo necessary

surgical procedures.

Neuropsychological assessments can also be applied in research and forensic

contexts. From a research standpoint, assessments are included in a wide array of

research protocols, including those reporting slower processing speed abilities among

soldiers with comorbid traumatic brain injury and post traumatic stress (Nelson, Yoash-

Gantz, Pickett, & Campbell, 2009). Another recent study comparing neurocognitive

functions among preterm and full-term children found that preterm children performed

worse on neuropsychological measures of processing speed, certain aspects of attention

and executive functioning, visual-motor coordination, as well as face processing and

emotion regulation (Potharst et al., 2013). Neuropsychologists are also increasingly

called to the stand to address issues in the legal arena, such as the economic

(employment) consequences of traumatic brain injury (Bigler & Brooks, 2009). In

criminal cases, a neuropsychologist may be called to assess a defendant’s mental capacity

to stand trial or to explain how neuropsychological factors may help explain criminal

behavior (Raine, 2013, p. 309-310).

Clearly, this cursory overview of the applications of neuropsychological

assessment does not do justice to the myriad ways in which neuropsychological

assessments can help individuals with cognitive, intellectual, and physical impairments.
The interested reader is encouraged to find a more comprehensive review of

neuropsychological assessment, with some suggestions provided below.

Malingering

Before delving into a discussion of specific assessments, it is essential to

understand how malingering may influence a neuropsychological assessment. Clinicians

should always assess malingering in the context of a neuropsychological assessment.

Malingering is defined as the intentional generation of false or grossly exaggerated

symptoms, and can be done in two primary ways: (a) deliberate exaggeration of

symptoms that are difficult to measure; and (b) intentional poor performance on

psychological and neuropsychological tests (Iverson & Binder, 2000). Although

malingering generally occurs in certain situations, including those in which individuals

are suing for worker’s compensation, are seeking a declaration of “incompetence” to

avoid standing trial, or are trying to plead insanity in a criminal case, psychologists

should always be cautious of this phenomenon when working with any patient.

Malingering may manifest in various ways: individuals may exaggerate memory loss,

poor concentration, personality changes, or other bodily or cognitive symptoms.

Psychologists have proposed several strategies for identifying malingering.

Larrabee (2003) identified clinically atypical patterns of performance on five

standardized psychological and neuropsychological assessments: Benton Visual Form

Discrimination, Fingertapping, WAIS-R Reliable Digit Span, Wisconsin Card Sorting

Failure-to-Maintain Set, and the Lees-Haley Fake Bad Scale from the MMPI-2. Using the

cut-offs established from his analyses, Larrabee was able to correctly identify 15 of 17

subjects meeting criteria for probable malingering. These findings suggest that examiners
can utilize “built-in” empirical methods for assessing malingering without having to

administer additional assessments.

Selecting an Assessment Battery

Before selecting an assessment battery, it is first necessary to determine the

purpose of the assessment. More specifically, the clinician should have a clear picture of

the patient’s referral questions, as well as an understanding of what the patient can gain

from the assessment (e.g., specific accommodations, such as a distraction-free testing

environment). A patient being evaluated for a possible ADHD diagnosis may require a

very different battery from someone who needs an assessment following a traumatic

brain injury. One of the benefits of neuropsychological testing is that it allows for the

selection of tests that tap into specific cognitive functions, and more importantly, a

battery can be tailored to the individual needs of the client.

Mini Mental Status Exam

The Mini Mental Status Exam (MMSE; Folstein et al., 1975) is not a standardized

neuropsychological assessment per se, but it is a very important feature of assessment

that can oftentimes be used as a screening tool, mostly commonly as a screener for

dementia. This screener requires an individual to respond to questions in eight categories.

The first category addresses orientation to time (e.g., year, day of the week) and the

second addresses orientation to place (e.g., can the patient state where he or she is). Next,

the patient’s registration? is assessed, which is his or her ability to repeat three randomly

selected words. In order to assess attention and calculation, a neuropsychologist may ask

a patient to spell “world” backward or to count backward form 100 by 7’s.

 After some delay, the examiner will ask the patient to recall the three words she

had asked him to repeat verbatim earlier during the registration assessment. The examiner

may also wish to assess the patient’s language by asking him to name everyday objects

(e.g., the examiner’s pen). The patient may also be asked to repeat a phrase back to the

examiner exactly as she says it. The examiner may then conclude the MMSE by asking

the patient to carry out more complex commands (e.g., follow three-sequence series of

directions).

Cognitive Assessments

Intelligence. The Wechsler scales are among the most reliable and widely used

neuropsychological evaluations of intelligence. There are essentially three classes of this

assessment: the Wechsler Intelligence Scale for Children, 4th Edition (WISC-IV), which

is administered to children aged 6 years, 0 months to 16 years, 11 months; Wechsler

Adult Intelligence Scale, 4th Edition (WAIS-IV), which is administered to individuals

ages 16 years, 7 months to 90 years, 11 months; and an abbreviated version of these

measures, the Wechsler Abbreviated Scale of Intelligence, now in its second edition

(WASI-II), is available for individuals aged 6 years, 0 months to 90 years, 11 months.

The WAIS-IV and WISC-IV subtests are grouped into four indices or factors, and

one global composite score, which is known as the Full Scale IQ (FSIQ). The four factors

include Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing

Speed. The Verbal Comprehension Index (VCI) taps verbal reasoning and knowledge of

word meanings; the Perceptual Reasoning Index (PRI) taps spatial visualization, visual

relationships, and nonverbal reasoning; the Working Memory Index (WMI) taps short-

term auditory information and the ability to hold and manipulate information in memory;
and the Processing Speed Index (PSI) assesses overall speed of information processing

and the ability to screen out irrelevant stimuli.

Both the WISC-IV and WAIS-IV have 10 subtests (although the specific subtests

on each assessment vary, as will be discussed below); 3 subtests comprise the VCI, 3

subtests comprise the PRI, and 2 subtests each comprise the WMI and PSI. Additionally,

on both the WAIS-IV and WISC-IV, the 3 verbal comprehension subtests and 3

perceptual reasoning subtests can be utilized in the calculation of the General Ability

Index (GAI), which is useful when the FSIQ is uninterpretable. The FSIQ may be

uninterpretable in cases where the difference between the highest Index and the lowest

Index exceeds 1.5 standard deviations or 23 points (Cite Essentials of WISC Assessment

by Flanagan).

The three subtests that tap into the Verbal Comprehension Index on the WAIS are

the similarities subtest, vocabulary subtest, and the information subtest. There is also a

supplemental comprehension subtest. The three subtests that tap into the Perceptual

Reasoning Index are the block design subtest, matrix reasoning subtest, and the visual

puzzles subtest. The two supplemental subtests that tap into this Index are the picture

completion and figure weights subtests. The Working Memory Index is comprised of two

core subtests, digit span and arithmetic, as well as one supplemental subtest, letter-

number sequencing. The two subtests making up the Processing Speed Index are symbol

search and coding, with an optional cancellation subtest.

The organization and administration of the WISC-IV are very similar, but some of

the individual subtests comprising the indices differ from the WAIS-IV. Three subtests
comprise the VCI, including vocabulary, similarities, and comprehension, with optional

information and word reasoning subtests.

The WAIS-II is an abbreviated measure of intelligence, with options of

administering two or four subtests to generate the FSIQ (Cite manual). The two-subtest

form requires the administration of the vocabulary and matrix reasoning subtests, and

only yields the FSIQ. The four-subtest form requires the examiner to administer the

vocabulary, similarities, block design, and matrix reasoning subtests, and generates a

FSIQ-4, a VCI score, and a PRI score. Whereas the WISC and WAIS each take anywhere

between 60 and 90 minutes to administer to core battery, the WASI-II can take about 15

(2 subtests) to 30 minutes (4 subtests), thereby increasing efficiency in the clinical or

research setting.

The Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition

(WPPSI-IV) is also available to test younger populations (2 years, 6 months to 7 years, 7

months), and provides similar information as the other Wechsler instruments. The 14

core, supplemental, and optional subtests combine to generate five Primary Index scales.

These scales include a Verbal Comprehension Index (VCI), Visual Spatial Index (VSI),

Working Memory Index (WMI), Fluid Reasoning Index (FRI), and Processing Speed

Index (PSI). A Full Scale IQ is also calculated. The WPSSI-IV has adequate reliability,

and improved normative sampling from previous editions (cite manual). Furthermore, the

age range was extended from 7 years, 3 months (which was the maximum age in previous

versions of the WPPSI) to 7 years, 7 months in the present standardized version.

The Differential Abilities Scale, 2nd Edition (DAS-II; Elliott, 2007) is another

cognitive assessment that is available for those testing children. The DAS-II provides
scores reflecting verbal, nonverbal, and spatial abilities, as well as a composite measure

of general cognitive ability (General Conceptual Ability score, GCA). The GCA is the

‘general ability of an individual to perform complex mental processing that involves

conceptualization and the transformation of information” (CITE MANUAL, p.17). In

addition to the composite measure, two or three lower-level composite or cluster scores

can also be calculated. These cluster scores vary by age. The DAS-II is divided into two

batteries, an Early Years Battery (2 years, 6 months to 6 years, 11 months) and a School

Age Battery (7 years, 0 months to 17 years, 11 months).

The DAS-II has shown very good internal reliability, with subtest coefficients

ranging from 0.74 to 0.96 across both the Early Years and School-Age batteries.

Interrater rater among subtests requiring examiner judgment (e.g., Copying, Recall of

Designs) reliability was also high, ranging from 0.95 to 0.99. There is also evidence for

the high internal validity of the DAS-II (Davis, Finch, & Tindal, 2012).

Executive Functioning. One common assessment of executive functions is the

Delis-Kaplan Executive Function System (D-KEFS), which compromises nine tests

designed to tap into various verbal and nonverbal executive functions. Each of the nine

subtests generates its own information about an individual’s performance, eliminating the

need for an overall composite score. In fact, one of the many strengths of the D-KEFS is

that it provides great flexibility in administration because the examiner can choose only

those specific subtests that will answer the assessment question, and does not have to

administer a predetermined number of tests before obtaining a clinically significant index

score (cite manual).

 The D-KEFS has been shown to have impressive test-retest reliability, as well as

high internal consistency on the Trail Making Test, Verbal Fluency Test, and Color-Word

Interference Test (Cite Mental Measurements Yearbook). The authors of the manual also

explain that factor analytic studies aimed at deriving index scores were not necessary

given that each test is designed to be a stand-alone measure. The D-KEFS can be

administered across several developmental periods, from ages 8 through 89.

Sometimes, clinicians must diagnose neuropsychological functioning in younger

individuals, and when this becomes the case, tests like the D-KEFS are not normed for

these younger populations. As such, it may be necessary to use a test like A

Developmental Neuropsychological Assessment (NEPSY-II) in order to test these

younger populations. The NEPSY-II is available in two forms, one for 3 to 4 year-old

patients (Pre-school Age), and one for 5 through 16 year-old patients (School Age). The

six functional domains of the NEPSY-II were derived theoretically rather than

empirically. These six domains cover attention and executive functioning, language,

memory and learning, sensorimotor, social perception, and visuospatial processing). Like

the D-KEFS, the NEPSY-II is a very versatile assessment, with selection of subtests

being based on the referral question. Subtests can provide an overview of

neuropsychological functioning, a diagnostic measure specific to the referral question, a

selective assessment to determine information about cognitive abilities, or the examiner

can provide a comprehensive neuropsychological evaluation (D’Amato & Hertiage,

2008).

Memory Assessment
 One of the best-known memory assessments in the field is the Wechsler Memory

Scale, Fourth Edition (WMS-IV). This assessment is comprised of seven subtests that tap

into five Index Scores: Auditory Memory, Visual Memory, Visual Working Memory,

Immediate Memory, and Delayed Memory. The WMS-IV can be administered to

adolescent and adult patients (16 years, 0 months through 90 years, 11 months).

The California Verbal Learning Test, Second Edition (CVLT-II) is another

measure used to specifically evaluate verbal memory, and is available for adolescents and

adults (16 years to 89 years), as well as for children (5 years, 0 months through 16 years,

11 months). In both assessments, individuals are asked to recall a list immediately, after a

delay, with interference, and with or without cues.

Another memory assessment that was uniquely designed for children is the

Children’s Memory Scale (CMS), which is normed for children ages 5 to 16. Unlike the

CVLT, which is specific to verbal memory, the CMS assesses a broader range of memory

dimensions, including attention and working memory, recall and recognition, short-delay

and long-delay memory, as well as both verbal and visual memory (CITE manual).

Finally, the Test of Memory and Learning, Second Edition (TOMAL-2; cite) is a

comprehensive memory assessment available for children and adults (5 years, 0 months

to 59 years, 11 months). The assessment consists of eight core subtests, six supplemental

subtests, and two delayed recall tasks. These various subtests generate three core Indices

(Verbal Memory Index, Nonverbal Memory Index, and Composite Memory Index) and

six supplemental Indices (Verbal Delayed Recall Index, Learning Index, Attention and

Concentration Index, Sequential Memory Index, Free Recall Index, and Associative

Recall Index).
Motor Functions

The Finger Tapping Test (FTT; Reitan & Wolfson, 1993) is one of the most

widely recognized tests of manual dexterity. Previous studies have found that individuals

with traumatic brain injuries will have a slower average number of taps in a 10-second

interval than healthy controls (CITE).

The Peabody Developmental Motor Scales, Second Edition (PDMS-2) assesses

fine and gross motor skills among children from birth to five months. The PDMS

assesses both quantitative and qualitative aspects of motor development among children.

For example, a child’s grasp is evaluated and judged by an examiner as to whether or not

the grasp is mature for the child’s age. In order to obtain quantitative measures, a child

may be timed as she tries to grasp a cube. The developers of the PDMS believe that the

quantitative information gathered during the assessment may be especially useful in

developing remediation strategies. The six subtests of the PDMS assess various

milestones of fine and gross motor development, including grasping, locomotion, object

manipulation, body control and equilibrium, and visual motor integration (cite manual).

Academic Functioning

While academic problems and specific learning disabilities are typically assessed

using structured psychoeducational batteries, it is not uncommon to also find

psychoeducational measures in some neuropsychological batteries, depending on the

reason for referral. For example, a child with sickle cell anemia may present with recent

academic difficulties, including problems with attention and reading comprehension.

Upon further medical examination, it is determined that this child has experienced a

series of silent strokes, one of the many typical complications of his disorder. He is
referred for a neuropsychological evaluation to determine the cognitive consequences of

his strokes, but in order to obtain special accommodations at his school, the

neuropsychologist may need to provide evidence that the cognitive impairments influence

the academic concerns that were reported. In this case, using standardized measures of

academic functioning may prove to be very useful in identifying specific areas of

academic concern.

One well-known and widely used measure of academic functioning is the

Woodcock-Johnson, Third Edition Tests of Achievement (WJ-III ACH; cite manual).

The Standard Battery includes 12 subtests that assess performance in areas such as

reading, oral language, math, written language, and general academic skills, and certain

subtests can be administered to individuals as early as 2 years of age. The different start

points within each subtest are determined based on the individual’s level of schooling

rather than age.

The Wechsler Individual Achievement Test, Third Edition (WIAT-III) assesses

reading, math, writing, and oral language in a total of 16 subtests. It is a useful tool for

identifying academic strengths and weaknesses, and can inform an examiner’s decision

about the presence of a learning disability.

Specialized assessments of various academic subjects are also available, but are

beyond the scope of this chapter. Examples of these assessments would be the

KeyMath3 (CITE), the Gray Oral Reading Tests- Fifth Edition (Cite), the Clinical

Evaluation of Language Fundamentals- Fourth Edition (CITE), and the Test of Written

Language-Fourth Edition (CITE).

Personality Assessment
 Similarly to academic functioning, personality assessment is not necessarily a

core feature of neuropsychological batteries. Nevertheless, in some cases, it may be

necessary to assess an individual’s personality in order to obtain a complete picture of

present psychosocial functioning. Furthermore, as was discussed above, specific scales of

certain personality assessments can be used to inform the neuropsychologist about

possible malingering, especially in “high-stakes” assessment (e.g., assessing someone

who would like to use the insanity defense).

Although there are a wide variety of personality assessment measures available,

one way to distinguish these measures is to classify them as “projective” or “objective.”

Projective measures allow an individual to respond to ambiguous stimuli, and it is

thought that these responses may reveal important characteristics about an individual’s

hidden emotions. Some of the better know projective measures include the Rorschach

Inkblot Test, the Thematic Apperception Test, and the Draw-A-Person test. For the

purposes of this chapter, emphasis will be placed on the “objective” measures of

personality, such as the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; CITE)

and the Personality Assessment Inventory (PAI). Unlike the projective tests listed above,

objective tests require the individual examiner to answer specific questions typically

presented in a multiple-choice format. Their responses are then compared to responses

generated from the normative samples utilized in the creation of the assessment.

The MMPI-2 is a 567-item questionnaire that is composed of over 120 scales, 10

of which are the well-known “clinical scales.” A strength of the MMPI is its use of

validity indicators, which can be useful to detect threats to a valid administration, such as

malingering, response inconsistency, and superlative self-presentation (CITE). The 10

clinical scales on the MMPI-2 are (1) hypochondriasis; (2) depression; (3) hysteria; (4)

psychopathic deviate; (5) masculinity/femininity; (6) paranoia; (7) psychasthenia; (8)

schizophrenia; (9) hypomania; (0) and social introversion. On the clinical scales of the

MMPI-2, a T-score of 65 is considered clinically significant, but these elevations should

be interpreted in light of other psychosocial variables, which can typically be gleaned

from a clinical interview with the participant. An adolescent version (MMPI-A) was also

developed, and is currently one of the most commonly used assessments of personality

among adolescents (Merrell, 2008).

The Personality Assessment Inventory (PAI) provides an assessment of

psychopathology in individuals ages 18 to 89. There are 344 items on this assessment,

and together they make up 22 scales, including four validity scales, eleven clinical scales,

five treatment scales, and two interpersonal scales. This measure has been found to have

high internal consistency, convergent validity, and discriminant validity (CITE manual).

An adolescent version (PAI-A) is also available.

Behavioral Assessment

Behavioral ratings can also be used to supplement formal neuropsychological

assessments, but are not necessarily core features of a neuropsychological battery. Since a

neuropsychologist only evaluates an individual for a few hours, it is difficult to obtain a

clear picture of this individual’s behavioral context outside the testing session. As a

result, administration of behavior rating scales to the individual, caregivers, parents, and

other important individuals with whom the client interacts can provide a wealth of

information about possible problematic behaviors the client may be experiencing. In

certain contexts, such as an evaluation of a possible ADHD diagnosis, behavior-rating

scales are critical in ascertaining that the characteristic ADHD behaviors of impulsivity

and/or inattention occur across several contexts.

While there are certainly several empirically validated rating forms available

(e.g., Child Behavior Checklist, Behavior Assessment System for Children, etc.), this

chapter will focus on briefly describing the Behavior Rating Inventory of Executive

Function (BRIEF), which can be used to supplement neuropsychological evaluations of

impairments in executive functioning (CITE). This questionnaire is available for parents

and teachers of children ages 5 to 18. There are also adolescent self-report forms

(BRIEF-SR), pre-school age forms for children between the ages of 2 to 5 (BRIEF-P),

and self and informant rating forms for adults ranging in age from 18 to 90 (BRIEF-A).

While the number of items on each of the versions of the BRIEF differs, the

overall clinical scales tap into the same constructs, including working memory, emotional

control, inhibition, and planning/organization. Overall, the BRIEF’s good reliability,

validity, and clinical utility make this a useful addition to any neuropsychological battery

where questions of cross-situational impairment may arise.

The Report

After evaluating a client, a neuropsychologist generally writes a report

summarizing the referral questions, pertinent background information, data gathered from

the neuropsychological testing sessions, an interpretation of the data, and formal

recommendations and/or accommodations for the patient. After stating the referral

summarizing the referral question and reasons for the assessment, the neuropsychologist

will then highlight relevant background history information. This section may include

information about developmental milestones, medical history, academic history,

employment history, and any significant injuries, hospitalizations, etc. The behavioral

observation section of the report that outlines information about the client’s mood,

affective state, as well as any observations that clinician made about the client’s

performance, effort, and/or behavior across the different tests. Based on these

observations, a clinician should include a statement reflecting whether she or he believes

the results of the assessment are an accurate reflection of the client’s current level of

functioning. Next, the clinician generally presents the data gathered from the assessment

batteries that were administered, explaining why certain assessments were selected, and

what conclusions can be drawn about the individual’s functioning across the various

domains of functioning that were assessed.

After the data are thoroughly presented, the report typically concludes with a brief

summary of the referral question, relevant background information, and a condensed

overview of the findings. This portion of the report should emphasize the most important

findings clearly and concisely so that it is apparent how the diagnostic impressions

(which are listed after the summary) were determined. Finally, the clinician concludes the

report with important accommodations and recommendations that the individual, his or

her family, other professionals, etc. may find to be useful in treatment planning, academic

planning, or judiciary proceedings.

Concluding Comments and Future Directions

Neuropsychological reports can be used in a variety of settings, and for a variety

of purposes. Parents can use these reports to help their children obtain 504 plans or

Individualized Educational Plans (IEPs). Neuropsychological reports can also be used in

forensic settings to determine whether someone is mentally fit to stand trial or to help an
individual obtain worker’s compensation in a lawsuit. Because individuals rely on these

reports for sometimes life-changing purposes, it is essential to obtain and maintain

competence in assessment before administering, scoring, and interpreting a

neuropsychological battery (CITE APA ethical code…includes two standards pertaining

to competence?). Furthermore, the neuropsychologist should make every effort to meet

with the patient, her family, or both in order to communicate the findings of the

assessment, explain the recommendations and/or accommodations, and answer any

questions the patient and his or her family may have.

Neuropsychological assessment can provide valuable insight about the current

state of functioning of individual patients, and can enable a clinician to make

recommendations about treatment and services that an individual may need to thrive in

spite of having neuropsychological deficits. It is the authors’ hope that this very brief

introduction has introduced the reader to some of the more widely used

neuropsychological assessments, to their utility, and to their applicability across various

domains.

All of the assessments listed above are administered using pencil, paper, and

stimulus materials. As newer assessments are developed, test developers are taking

advantage of newer technologies to create standardized assessments that can be

administered entirely on computers and tablets CITE). Not only does the portability of

standardized assessments increase administration efficiency, but it also enables examiners

to administer assessments in less time and simplifies the scoring process by having all

necessary materials in one place (the tablet/computer). The CVLT-II is one example of a
standardized measure that can now be administered in its entirety using this tablet-based

system.

References (I will add/format this section once we have finalized the chapter)

Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4-18 & 1991 Profile.
Burlington, V.A.

Bigler, E. D., & Brooks, M. (2009). Traumatic brain injury and forensic
neuropsychology. The Journal of head trauma rehabilitation, 24(2), 76–87.
doi:10.1097/HTR.0b013e31819c2190

Davis, A. S., Finch, W. H., & Tindal, G. (2012). Review of the Differential Ability
Scales- Second Edition. The eighteenth mental measurements yearbook.
Retrieved October 08, 2013, from
http://web.ebscohost.com.proxy.library.emory.edu/ehost/detail?
vid=3&sid=5d96d09d-1f1d-456a-9c9c-
e8ce4ddf1e23%40sessionmgr110&hid=103&bdata=JnNpdGU9ZWhvc3QtbGl2
ZQ%3d%3d#db=loh&AN=18013504

Elliott, C. D. (2007). Differential Ability Scales-II (DAS-II). Pearson Education, Inc.

Iverson, G. L., & Binder, L. M. (2000). Detecting exaggeration and malingering in

neuropsychological assessment. The Journal of head trauma rehabilitation,
15(2), 829–58. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/10739970

Larrabee, G. J. (2003). Detection of Malingering Using Atypical Performance Patterns

on Standard Neuropsychological Tests Detection of Malingering Using Atypical
Performance Patterns on Standard Neuropsychological Tests. The Clinial
Neuropsychologist, 17(3), 37–41.

Lezak, M. D., Howieson, D. B., & Loring, D. W. (2004). Neuropsychological assessment

(4th ed.). Oxford: Oxford University Press.

Merrell, K. W. (2008). Behavioral, social, and emotional assessment of children. New

York: Routledge.

Nelson, L. a, Yoash-Gantz, R. E., Pickett, T. C., & Campbell, T. a. (2009). Relationship

between processing speed and executive functioning performance among
OEF/OIF veterans: implications for postdeployment rehabilitation. The Journal
 of head trauma rehabilitation, 24(1), 32–40.
doi:10.1097/HTR.0b013e3181957016

Potharst, E. S., van Wassenaer-Leemhuis, A. G., Houtzager, B. a, Livesey, D., Kok, J. H.,
Last, B. F., & Oosterlaan, J. (2013). Perinatal risk factors for neurocognitive
impairments in preschool children born very preterm. Developmental medicine
and child neurology, 55(2), 178–84. doi:10.1111/dmcn.12018

Raine, A. (2013). The anatomy of violence: The biologial roots of crime. New York:
Pantheon Books.

SEE ALSO:

Lezak, M. D., Howieson, D. B., & Loring, D. W. (2004). Neuropsychological assessment

(4th ed.). Oxford: Oxford University Press.