Emic Norms - Answers Norms that are specific to the individuals identities/qualities
experience near
Etic Norms - Answers Norms that are generalized to the population as a whole
experience-distant
EIWA - Answers Wechsler Spanish Subtest
Escala de Inteligencia de Wechsler para Adultos
Using English vs Spanish Language Norms - Answers Healthy Elderly (Spanish speaking < English
speaking) - suggests that using English norms in this population may be overpathologizing, supports idea
that tests are bias
Alzheimer's Elderly (Spanish speaking > English speaking) - suggests that using English norms in this
population may be underpathologizing, suggests tests are less able to detect deficits
For a given individual, multiple norms might be useful. A neuropsychologist should provide conceptually
informed data to support a given set of norms for a given individual.
Hypotheses/assumptions to consider when an individual is different from test norms - Answers - you can
not assume that there are no
biases in tests
- nor can you assume there are biases in
tests
The role of functioning in assessment - Answers - Important to consider what the individual is and is not
able to do in their every day life to conceptualize assessment results
,Topics included in clinical interview - Answers - Presenting concerns: Cognitive, emotional, physical
- Functioning: IADLs, work, school, recreation
- Medical history: Stroke, seizures, head injury, medication and medical conditions (often gathered from
medical record), family medical history
- Psychiatric history: prior symptoms, diagnoses, treatment
- Substance use: current use and prior history
- Developmental background: where born/raised, language background, early development
- Educational/Occupational: education completed, quality of their education is important
- Work history - any troubles/lapses?
- Social: relationships and current support
Important tip for clinical interviews - Answers Don't make assumptions!
Making assumptions about clients can lead you to not ask certain questions that may be important for
the client (ex: not asking about drug use in older people, etc.)
Behavioral observation section of clinical interview - Answers - can provide context for what they were
like on the day of testing and whether their test performance could've been impacted
- Mood, affect, appearance, tardiness (say why), accompanied, orientation (person, place, time), arousal
level, eye contact, rate of speech, thought process (logical, tangential), motor abnormalities (gait,
tremor), disabilities, sensory problems (vision, hearing), insight, judgement, effort (poor, constant or
fluctuating), frustration tolerance (poor if they give up easily), anxiety
- A&Ox3 = oriented to person, place time
- A&Ox4 adds situation
- try to stay as objective as possible and report evidence for any claims that you make
Mood vs Affect - Answers Mood - patients subjective experience, what they report
Affect - experimenters subjective observations on their affect
,- for affect there is range (indicates different states; ex: constricted) and intensity (ex: reduced
emotions)
Affect descriptors: Normal, blunted, flat or labile (all over the place)
Speech vs Language - Answers Speech - motoric, the actual quality of the speech rather than the
content; rate, volume, prosody , slurred
Language - the actual content of what they are saying; receptive - being able to understand; expressive-
being able to express
Reporting appearance - Answers - "Casually dressed and appropriately groomed" is the standard
- Grooming was moderate - communicates less than ideal grooming
- Dressed neatly - better than average
- Report anything in their appearance that is outside of social norms?
Levels of arousal - Answers - alert, drowsy, lethargic, obtunded, stupor, coma
- If not alert, will want to get context (Lack of sleep? Will it influence performance? Should you
reschedule?)
MoCA - Answers - Montreal Cognitive Assessment
- Cognitive assessment design for older adults (55+)
- sensitive to mild cognitive impairment (risk of false positive errors)
- norms with data stratified by age, education, and ethnicity
- 3 versions for retesting
- versions in different languages
- supposed to take 10 minutes but can take 30 mins with impaired patients
- floor effects for more impaired patients
- should fold form so that they can focus on one task at a time
- norm sample of older healthy controls, MCI, and Alzheimer's groups
, - Cutoff score of 26 used to differentiate between groups
- Subtests: visuospatial/executive, naming (animal pictures), memory, attention, language, abstraction,
delayed recall, orientation
MMSE - Answers - Mini Mental Status Examination
- Measure of cognitive impairment
- Less visual, less rich, not as sensitive as MoCA
- MoCA has more executive functioning tasks , more repetition, more fluency
- cutoff of < 26 is generally clinically relevant (higher for highly educated patients)
Stimulus Bound - Answers - When asked to copy a picture of a shape, they may draw the copy right over
or overlapping on the example
- For block design, they may try to create the pattern right on top of the example
Nervous System Components - Answers Central nervous system - brain and spinal cord
Peripheral nervous system - cranial nerves and spinal nerves
Number of neurons in a human brain - Answers 86 billion
Half of them are in the cerebellum
Neurotransmitters - Answers - glutamate - CNS, excitatory
- GABA - CNS, inhibitory