Graduation date: 2006

Thesis (Ph. D.)--Ball State University, 2009. / Title from PDF t.p. (viewed on Nov. 12, 2009). Includes bibliographical references (p. 73-82).

Virtual-reality neuropsychological tests offer a novel way to assess real-life executive functioning within the context of standardized test conditions whilst maximizing ecological validity. Given the limited empirical evidence base for many of these virtual-reality tests, the current study aimed to further examine the relative ecological validity, sensitivity to brain-injury and diagnostic accuracy of the virtual-reality based Jansari assessment of Executive Functions (JEF). To do this, the test was compared to seven standard tests of executive function, in a New Zealand sample of 27 brain-injured and 28 non brain-injured participants matched for age, gender and education. The JEF’s ecological validity was supported, with JEF total percent scores exhibiting large correlations with participants’ independently reported levels of everyday functioning, as measured by the Dysexecutive Questionnaire: Independent-Rater (DEX-IR) and Patient Competency Rating Scale-Relative (PCRS-R) (both rs = 0.606, p < 0.001). Compared to the standard executive function test variables included in the current study, the JEF’s associations with the everyday functioning measures were the largest, but only significantly larger than the respective correlations of some standard executive function test variables. These results indicated that the JEF is trending towards being relatively more ecologically valid than most of the standard executive function tests included in the study. The JEF also exhibited good sensitivity to brain-injury and diagnostic accuracy for discriminating brain-injured from non brain-injured participants, which was generally consistent with most of the standard tests, but only significantly better than some. These results provide empirical support for the JEF’s clinical utility, particularly in the assessment of brain-injured persons’ functional abilities. It also suggests that both virtual-reality and standard executive function tests have a place in the routine neuropsychological test batteries used to assess brain-injured persons.

The impetus behind this investigation was a little-understood syndrome of retarded language development known as developmental dysphasia. Little agreement exists with respect to the characterization of children classified dysphasic, and even less is known regarding the etiology of this problem. One theoretical position postulates a lag in the maturation of systems relevant to language acquisition. A second position is oriented toward specific deficits which impede the development of language skills in some children. An emerging theme ties the difficulties of dysphasic children to some type of cerebral dysfunction. Another issue concerns the scope of the problems of developmentally dysphasic children. The bulk of research in this area focuses on language-related measures although it has been suggested that the difficulties underlying developmental dysphasia may extend to non-language areas. The paucity of studies of non-language abilities of dysphasic children has contributed to conceptualizations of developmental dysphasia as exclusively a language-related problem. The principal aim of this investigation was to attempt to characterize children with developmental dysphasia within a neuropsychological context, evaluating the adequacy of current theories concerning the etiology of developmental dysphasia and looking at the abilities of dysphasic children in non-language areas. A group of children classified as developmentally dysphasic were compared with groups of normal and brain damaged children on measures of language (Reitan-Indiana Aphasia Screening Test), sensory-perceptual (Reitan-Klove Sensory-Perceptual Examination), and motor (Finger Oscillation Test and grip strength) abilities. A scoring procedure was designed which allowed for the qualitative evaluation of responses as they relate to the integrity of brain functions. Results indicated that children with cerebral damage perform more poorly than do control subjects on measures of normal language and sensory-perceptual and motor abilities, showing evidence of abnormalities across all areas. Children in the dysphasic group performed deficiently in the language area and had difficulties in the sensory-perceptual area. Motor performances of children in the dysphasic group, were substandard when compared to the motor abilities of normal children. These results support a theory of brain dysfunction as a contributing factor in the retarded development of language and other abilities in developmentally dysphasic children.

Attention Deficit Hyperactivity Disorder (ADHD) is a relatively common psychiatric disorder affecting 5-10% of child and 4% of the adult population. The disorder involves both behavioural problems and cognitive deficits, which are believed to be associated with neurological differences seen in this population. There has been increasing interest in understanding the cognitive deficits and neurological basis associated with ADHD. Neuropsychological examinations are an affordable tool, which can be used to improve our understanding of the cognitive deficits associated with the disorder and aid in clinical care. Currently, there is no standardized neuropsychological assessment that can be used in this population. In order to assist in developing a sound, predominately computerized test battery, which would assess deficits commonly seen in adults with ADHD, a neuropsychological project was piloted to examine recruitment and test utility. The majority of the tests were computerized and had population norms. The test battery was piloted on 8 patients on and off medication, and 4 patients completed the test battery twice off medication to examine potential practice effects. A discussion of feasibility and utility of the neuropsychological test battery for adults with ADHD ensues.

A study was conducted, comparing the relationship between the Bender-Gestalt Test and the Trail-Making Test in brain-damaged patients. The study revealed a moderate negative correlation between the scaled score of the Trail-Making Test and the psychopathology scale of the Hutt Adaptation of the Bender-Gestalt Test. This relationship indicates that a number of skills might be tapped by both of these tests in brain-damaged patients. A further analysis showed that the correlation between the Trail-Making Test A and three factors of the Bender-Gestalt Test, Use of Space I, Collision, and Elaboration, were found to be significant (.05). In addition, the Trail-Making Test B is significantly correlated with the following factors of the Bender-Gestalt Tests Sequence, Use of Space I, Collision, Perceptual Rotation, and Retrogression (.05).This investigation discussed a number of skills and abilities which might be important on the performance of these tests in brain damaged patients, namely: anticipatory planning, visual organization, and shifting. Furthermore, overt anxiety has been considered one of the factors which might affect the performance of the brain-damaged patients on both tests.

A differential diagnosis between head injury and depression is critical to ensure proper treatment and appropriate interventions. Knowledge about this can only aid counseling psychologists' work with this population and, identifying a measure that can assist in this process is essential. The purpose of this study is to measure the utility of the Dean — Woodcock Neuropsychological Assessment System (D-WNAS) in distinguishing individuals with head injury from those who have a primary diagnosis of depression, and general neurological impairment. Participants included 433 adults (222 males, 211 females) between the ages 20-55 years of age (mean = 35.3 years, SD = 10.97 years) from the Midwestern United States. During the individual's treatment in the neuropsychological laboratory, each person was administered the following: the Dean-Woodcock Structured Interview (Dean & Woodcock, 1999), mental status exam, the Woodcock Johnson — Revised Tests of Cognitive Ability (WJ-R COG; Woodcock & Johnson, 1989b), the Woodcock Johnson — Revised Tests of Achievement (WJ-R ACH; Woodcock & Johnson, 1989a), and the Dean-Woodcock Sensory Motor Battery (DWSMB; Dean & Woodcock, 1999). This study indicates that responses to D-WNAS can be used to reliably classify adults into groups of depression, head injury, and general neuropsychological impairment. In particular, responses to the D-WSMB portion of the D-WNAS can be used to reliably classify adults into groups of depression, head injury, and general neuropsychological impairment. Classification results revealed that the original grouped cases were classified with 62.6 % (p < .001) accuracy and with 73.2% overall accuracy when the head injury and general neurological impairment groups were combined and compared to depression and normative groups. The WJ-R COG and WJ-R ACH were not as reliable as the D-WSMB at predicting group membership. / Department of Counseling Psychology and Guidance Services

The main purpose of the present study was to identify sensory-motor deficits caused by closed head injury (CHI) when individuals with CHI are compared to a normal sample. The study also investigated lower-level sensory-motor functioning, such as gait, balance, and coordination and its relation to neurological impairment related to CHI. Additionally, the study determined if age significantly influenced sensory-motor functioning.Archival data was utilized to complete the study. Data was collected from a large, Midwestern neurology clinic (CHI) as well as from a normative sample of individuals with no reported history of neurological impairment. Preliminary analyses were completed to identify outliers. Samples were then randomly selected from the impaired group (CHI) and matched with randomly selected subjects from the normative sample based upon age.Three separate analyses were completed. The first analysis focused on age and if age significantly influences sensory motor functioning. The second analysis was completed using an adult's only sample based upon the results that age significantly influenced sensory-motor performance. Finally, the third analysis utilized all age groups to determine how dramatically age had an impact on distinguishing between individuals with CHI versus a normative sample.Results demonstrated that age had a significant influence on sensory-motor performance. Measures of subcortical and cortical motor function, motor speed, motor coordination and tactile examination were able to accurately classify individuals with head injury from a normative sample to a clinically significant degree (78%). The study argues that the D-WSMB is a reliable and valid measure to utilize when evaluating individuals with CHI. / Department of Educational Psychology

The present research concerned the exploration of the psychometric properties of a psychologically based screening measure of competency for use in civil legal proceedings. Specifically, the measure was designed to assess a person’s competency before executing a will or other important legal document. In a series of investigations, expert feedback was utilized to formulate the final version of the measure, possible scoring criteria, and overall goodness of fit to the research question. Additionally, reliability and factor structure of the competency measure were explored. In a two-part study, expert feedback was sought using the Direct Consensus Method to determine final question inclusion for the measure, as well as to create a preliminary scoring system, which could be compared against a random sampling of participants obtained in the second part of the study. The experts (N=49) were members of one of two groups (N = 22 first feedback, N = 27 second feedback). Using the expert feedback the measure was presented to a randomized sample of individuals (N=109) who were given the measure and then scored based on the experts proposed methodology. Under the proposed method of scoring none of the randomized normals would have been misidentified as incompetent. Finally, exploratory factor analysis was conducted using both a 2 and 3 factor model. Results from this analysis were inconclusive. / Department of Educational Psychology

The present investigation considered the utility of traditional psychoeducational measures in the prediction of neuropsychological impairment in learning disabled children. The subjects were 368 learning disabled children ranging in age from 9 to 14, with a mean age of 10.68 years, and a standard deviation of 1.62. In addition to traditional psychoeducational measures, each subject was administered the Halstead-Reitan Neuropsychological Battery for Older Children (HRNB-C). Subjects were considered impaired or nonimpaired on the basis of their score on the HRNB-C. A Discriminant Analysis was utilized to investigate what variables from the Wechsler Intelligence Scale for Children-Revised (WISC-R), Wide Range Achievement Test-Revised (WRAT-R) and the Peabody Picture Vocabulary Test-Revised (PPVT-R) would be used to predict the subjects' neuropsychological status. It was found that 12 variables added significantly (R < .05) to the prediction of impairment, with Arithmetic and Block Design subtests the most prominent predictors. A Regression Analysis was used to consider the subjects' score on the HRNB-C in a continous fashion. The regression equation that emerged showed the Performance Scale of the WISC-R to be the best predictor of the impairment index.MANOVA and ANOVA statistics were used to investigate the differences between the groups. Results indicated that there was a significant main effect for gender. Males tended to score higher than females on visual spatial tasks. General cognitive skills were lower in females than males. Overall, females tended to be more neuropsychologically impaired than males. / Department of Educational Psychology