This study was designed to determine the factorial validity of specific components of the Reitan-Indiana Neuropsychological Battery with a learning disabled population. Scores of 42 children, 38 males, 4 females, ages 6.2 to 8.8 years were compiled on specific tests of the Reitan-Indiana. Principal component factoring of the original correlation matrix was followed by principal factoring, using a 4 factor solution; varimax rotation with six iterations produced the desired reduction of the correlation matrix; four factors emerged for the learning disabled population, which accounted for 53% of the variance: verbal intelligence, psychomotor speed, achievement, and memory. The factor structure that emerged was not consistent with the surface factors of the battery as conceptualized by its author suggesting that this battery may lack construct validity when used with a learning disabled population.

Among the goals of the neuropsychological assessment are to detect the presence of brain damage, localize which areas of the brain may be dysfunctional and describe subsequent functional impairments. The sensitivity of neuropsychological instruments in carrying out these functions is a question of some debate. The purpose of this study is to determine the utility of lateralizing indicators from the WAIS-III, McCarron Assessment of Neuromuscular Development (MAND) and Haptic Visual Discrimination Test (HVDT), from the McCarron-Dial System Neuropsychological Assessment Battery (MDS), in ascertaining the presence or absence of brain damage as well as location of lesion. The classification accuracies of using performance level indicators from these tests and lateralizing indicators, alone and together, were compared.

This study investigated the effects of assessment context on state anxiety and attention according to the Mirsky (1996) model of attention. Context varied in the physical testing environment, demeanor of the assessor, and explanation of the purpose of testing. A relaxed condition (RC) and structured medical condition (SMC) distinction was made prior to data collection and the two contexts were designed to reflect contrasting practices of neuropsychologists. Elements of attention evaluated included Encoding (Digit Span), Focusing/Executing (Visual Search and Attention Test), Shifting (Wisconsin Card Sorting Test: Computerized Version 2), Sustaining, and Stabilizing (Continuous Performance Test-Identical Pairs). Eighty healthy adult females participated in the study. The findings suggest that the SMC caused higher levels of anxiety and lower valence than the RC, which in turn caused poorer sustained attention and superior shifting attention for this condition. Such interpretations are consistent with several theories on the effects of anxiety on attention. It should be noted, however, that differences observed in attention were limited to select measures. Factor analysis also indicates that the encode, shift, and sustain elements of attention were largely consistent with the factor solution proposed by Mirsky, while findings on the focus/execute and stabilize elements bring into question the construct validity of these aspects of the model. Findings from the study are considered relevant to those interested in attention theory and particularly researchers and clinicians involved in the administration of neuropsychological testing.

Ph.D (Industrial Psychology) / Brain injuries often occur suddenly and without warning, and from that instant, a normal life can be changed. Traumatic Brain Injury (TBI) may result in significant impairment of an individual’s physical, cognitive and psychosocial functioning. Although there is a fair amount of research on the concept of brain damage and the consequent effects on the family and return to work (RTW) prospects, there is far less information available on the actual assessment of workplace capability or workplace potential following the head injury incident. This is important, since the concept of work or job value has been well documented. Employment is far more than just a job; it not only provides for basic sustenance needs and decent living conditions, but also allows someone to fit into the world, create relationships, use talents and skills, learn, grow and build, and develop a sense of identity and belonging. While the value of work is well-documented, the statistics regarding unemployment following a head injury are concerning. It is estimated that approximately 1.5 million Americans sustain head injuries each year, with the majority of these people being under the age of 35 and in their prime years of vocational productivity. A baseline figure of 2% of the American population is currently living with disabilities as a result of head injuries. In South Africa, the rate of occurrence seems to be even more alarming, with published rates of 89,000 cases for 2009. In 2001, this was a baseline figure of 5% of the population living with disabilities resulting from head injuries. Various sources put the occurrence of head injuries in South Africa at 1.5 to 3.5 times higher than the estimated global rate. The negative impact of this on the individual, the family, community and economy is clear.

Abstract A revised Developmental Delay (DD) category became effective in Arizona on September 30, 2009 and allows children who demonstrate significant delays in at least two developmental areas to receive services in special education up to age 10. In order for the educational team to determine that a student meets the criteria for DD, an assessment in all five developmental areas, including cognitive, physical, communication, adaptive, and social/emotional must be completed. However, areas typically included in a neuropsychological assessment, like attention and executive functioning or memory and learning, are typically not part of an educational evaluation and have the potential to adversely affect learning when there are deficits in these areas. DD is a highly prevalent group that has a wide variety of genetic, environmental, and societal risk factors. The definition varies greatly in research, education, medical or health-related fields, as well as by culture. Since the DD category is viable until age 10, outcome studies have been conducted to find out if children with DD continue in special education and if so, under what categories. It has been found that children with DD generally stay in special education and continue receiving services, most often as students with specific learning disability, mild intellectual disability, and speech/language impairment, in addition to other categories. There is limited information in the available literature regarding the neuropsychological strengths and weaknesses for this prevalent group. Moreover, there is limited information available regarding the possible predictors of reading achievement for children with DD. The first aim of the study was to determine how much variability in performance there was for children who met the educational criteria for DD in Arizona as well as to assess strengths and weaknesses compared to normative means. The second aim of this study was to find out if two specific scores from a neuropsychological battery found to be significantly lower in children with a reading disorder were also significant predictors of reading performance in children with DD. A third aim involved an exploratory analysis to determine if there was evidence of a pattern of strengths and weaknesses by delay type. Thirty-three children with DD ages 5 to 9 years were recruited for this study from a single school district in Southern Arizona. Children were administered measures of cognition, attention and executive functioning, memory and learning, sensorimotor skills, and visuospatial processing, and reading. The parent/guardian of the child completed a structured developmental history. For the first aim, the total sample was split into two groups by presence of cognitive delay and analyzed separately. Qualitatively, the data in the form of box-plots was examined. Levene's and Nonparametric Levene's tests were used to quantitatively evaluate variance in score distributions. Single sample t-tests were used to compare group mean scale or subscale scores to the appropriate normative means. The second aim was analyzed using the total sample of children with DD. Stepwise linear regression models were used to determine if Speeded Naming and Inhibition Naming Total Completion Time scores significantly predicted reading performance as measured by the Reading Cluster score from the WJ IV ACH for all children with DD. Two other subtest scores, which were observed to be within normal limits in children with reading disorder on the NEPSY-II special group study, were also analyzed with stepwise linear regression to confirm that they did not predict reading in children with DD, namely Memory for Designs Total Score and Geometric Puzzles. Lastly, for the third aim, those with each delay type were analyzed separately from those without the delay type (e.g., no communication delay and communication delay). Like the first aim, box-plots were generated to visually represent the data. DD group mean scores of each scale or subscale were also compared to the appropriate normative means by single sample t-tests. Results from this study indicated that the variation in the scores was not significantly different between groups, except for a measure of graphomotor speed and precision. Children with DD with a cognitive delay were found to exhibit a wide range of deficits, including deficits in cognition, reading, attention and executive functioning, language, memory and learning, sensorimotor, and visuospatial processing. Children without cognitive impairment did not demonstrate impairments in cognition and reading and demonstrated specific skill deficits for sustained attention, speeded naming with accuracy, immediate and long-term visual memory, memory for organized verbal information, phonological short-term memory, and fine motor speed. When the total sample was analyzed together, three high reading scores were identified as outliers from group reading performance. Both predictor variables were found to be moderately related to reading whether the outliers were in or out. Only one of the two predictors were found to significantly contribute to the predictive model whether the outliers were in or out yet the strength of the prediction was weak, suggesting there are likely better predictors of reading for children with DD. In the analysis of the non-predictors, when the outlier scores were left in, Geometric Puzzles, a measure of visuospatial perception and mental rotation was indicated as a significant predictor of reading. When the outliers were removed, neither score was significantly related with reading. Lastly, meaningful group strengths and weaknesses were seen when the total sample of children with DD was broken into groups by delay, even when the majority performed below normative means. The results of this study indicate that children with DD are at increased risk for significant difficulties in many of the areas included in neuropsychological assessment. This points to the need for many of these areas, namely attention and executive functioning, memory and learning, and visuospatial processing to be included in a comprehensive evaluation in the school setting. Moreover, knowledge of group strengths and weaknesses can aid intervention selection and implementation in addition to appropriate accommodations to facilitate learning. This can inform intervention implementation and design. More research is needed in this area to have a better understanding of how neurocognitive skills relate to reading since the predictors selected for this study were not strong predictors of reading performance for children with DD. Visuospatial perception and mental rotation may be more highly related for children with DD that have higher reading skills.

To date, no research exists examining criterion-related validity of alternate, computerized forms of the Category Test. The intent of this study was to address criterion-related validity of three full forms of the Category Test. In that, the goal was to examine equivalency of each version in their ability to differentiate brain-injured from non-brain-injured individuals. Forty-nine (N = 49) healthy adults and 45 (N = 45) brain-injured adults were tested using three versions of the Category Test, the BDI, and the WAIS-R NI. ANOVA indicated no significant differences between versions of the Category Test or an interaction between Category Test version and group membership on the total error score. MANOVA performed between versions of the Category Test and Subtest error scores indicated significant differences between versions on Subtest 3 and Subtest 6. Group membership (brain-injured v. non-brain-injured) produced a significant main effect on all subtests of the Category Test except Subtest 2. Several exploratory analyses were performed examining the relationship between neuropsychological impairment, group membership based on Category Test error scores, and the WAIS-R NI. Clinical applications, such as the use of serial testing to index neurorehabilitation gains, were discussed.

Individuals undergoing forensic neuropsychological evaluation frequently stand to gain in some manner if neurocognitive dysfunction is diagnosed. As a result, neuropsychologists are customarily asked to test for neurocognitive feigning during the assessment. The current study employed an analogue design with a clinical comparison group to examine the utility of the TOCA (Rogers, 1996) as a measure of feigned neurocognitive impairment. Two groups of simulators (one cautioned about the presence of detection strategies and one not cautioned) were compared to clinical and normal control groups. Fourteen scales were developed based on five detection strategies: symptom validity testing, performance curve, magnitude of error, response time, and floor effect. Each was employed during both verbal and nonverbal tasks. Significant differences were revealed among groups when subjected to ANOVA. Classification rates from subsequent utility estimates and discriminant function analyses on the scales ranged from 58.8% to 100%. Combining strategies yielded a classification rate of 95.7%. The effect of cautioning simulators was modest; however, a trend was noted on some scales for cautioned simulators to appear less obviously impaired than noncautioned. Although the results require crossvalidation, preliminary data suggest that the TOCA is a sensitive and specific measure of feigned neurocognitive performance. Strengths and weaknesses of the study are discussed and directions for future research are proposed.

A avaliação neuropsicológica de portadores de doença de Parkinson (DP) tem sido de fundamental importância para definição de resultados em procedimentos clínicos, cirúrgicos experimentais ou para diagnóstico de demência nestes doentes. No entanto, ainda não existe consenso quanto aos testes neuropsicológicos necessários e padrões de comprometimento esperados. Este estudo objetivou comparar a produtividade das funções neuropsicológicas entre portadores da Doença de Parkinson, em diferentes estágios da doença, em relação aos indivíduos normais. Foram analisados 60 sujeitos (32 homens e 28 mulheres), emparelhados em relação à idade (média de 65,6 +-9,2) e instrução (média de 5,9 =- 4,0), distribuídos entre normais (n=20) e portadores de DP ambulatoriais, nos estágios leve a moderado (n=20) ou moderado a grave (n=20), de acordo com a escala Hoehn & Yahr. A bateria utilizou 24 testes neuropsicológicos abrangendo as funções de raciocínio, percepção visuoespacial, visuoconstrução, linguagem, memória, atenção e função executiva. Os resultados apontaram diferenças significantes (p < 0,01) entre vários testes e em todas as funções, exceto linguagem. Alguns instrumentos se mostraram mais adequados e outros se mostraram pouco indicados para avaliar estes doentes. Diferenças entre os estágios da doença só se evidenciaram nos testes que exigiam destreza motora. Este trabalho estabelece a adequação dos instrumentos e propõe uma bateria específica para avaliação destes doentes. A investigação de estados situacionais (nível cultural, sintoma afetivo e/ou limitações funcionais), manifestos na avaliação, permitiu estabelecer parâmetros para discriminar o modo como estas variáveis interferem na produção dos doentes de Parkinson. E conclui-se apresentando um método inovador de classificação para subsidiar com objetividade o diagnóstico neuropsicológico diferencial na DP. / The neuropsychological assessment of patients with Parkinson disease (PD) has been very important to define the results in clinical, experimental surgeries procedures or in the diagnostic of dementia of these patients. However, there is no consensus about the necessary neuropsychological tests and about the expected commitment patterns. This study aimed to compare the productivity of the neuropsychological functions among patients with Parkinson Disease, in different stages of the disease, in relation to normal people. Sixty subjects were assessed (32 men and 28 women), pared in relation to the age (average of 65.6 +- 9.2) and age of study (average of 5.9 +- 4.0), distributed among normal (n=20) and outpatients with PD, in the mild to moderate stages (n=20) or moderate to severe (n=20), according to Hoehn & Yahr Scale. The battery used 24 neuropsychological tests comprising the thinking, visuospatial perception, visuoconstruction, language, memory, attention and executive function. The results showed significant differences (p < 0.01) among many tests and in all the functions, except language. Some instruments were more suitable and others proved to be less indicated to assess these patients. Differences in the stages of the disease were highlighted in the tests that required motor ability. This work establishes the adequacy of the instruments and proposes a specific battery to assess these patients. The investigation of the situational state (cultural level, affective symptom and/or functional limitations), that appeared in the assessment, allowed to establish parameters to find out the way that these variables interfered in the Parkinson patients’ production. The work concludes presenting an innovative classification method to objectively subside the neuropsychological differential diagnosis for PD.

A dislexia é um transtorno específico de leitura que consiste em um rendimento na leitura e na escrita inferior ao esperado para a idade cronológica, para nível de escolaridade e para o nível de inteligência, sendo a eficiência intelectual adequada (QI 80). Os principais comprometimentos envolvem habilidades de competências linguísticas como dificuldade de consciência fonológica, memória fonológica, discriminação e nomeação. Estudos apontam relação entre as dificuldades na leitura e na escrita e fatores neurobiológicos. O objetivo deste projeto foi investigar se existem diferenças entre morfometria cerebral através de segmentação automática para análise de espessura e volume e diferenças entre o desempenho cognitivo em testes neuropsicológicos do grupo de indivíduos com dislexia comparados com um grupo controle pareado. Foi realizado um estudo prospectivo no qual participaram 30 crianças, sendo 15 indivíduos com dislexia e 15 controles pareados por idade e por sexo. Foram avaliadas habilidades cognitivas tais como: eficiência intelectual, funções de atenção, habilidade visuoconstrutivas e habilidades de linguagem oral e escrita. A morfometria cerebral foi baseada em sequência T1 volumétrica de ressonância magnética e segmentação automática com medida da espessura e volume utilizando o pacote de software FreeSurfer. Na avaliação neuropsicológica, as habilidades que se mostraram mais prejudicadas foram aspectos da memória e da linguagem oral e escrita, tais como rebaixamento de span de memória operacional fonológica e dificuldade de fluência verbal, de associação e integração de ideias, de definição/conceitos, de nomeação e principalmente de consciência fonológica, de leitura e de escrita. As análises de neuroimagem sugerem alterações estruturais no cérebro do grupo clínico com redução no volume de substância cinzenta em regiões corticais, tais como lobo temporal inferior esquerdo e lobo temporal médio direito, e redução no volume de substância branca de ambos os hemisférios. Não foram identificadas alterações significativas na espessura. As alterações estruturais observadas através das técnicas de imagem podem estar relacionadas às funções cognitivas que se mostraram afetadas. / Dyslexia is a specific reading disorder that consists of a performance in reading and writing lower than expected for chronological age, educational level and for the level of intelligence, with an adequate intellectual efficiency (IQ 80 ). The main commitments involve abilities of language skills as difficulty in phonological awareness, phonological memory, discrimination and naming. Studies show link between difficulties in reading and writing and neurobiological factors. The objective of this project was to investigate whether differences in brain morphometry using automatic segmentation for the analysis of thickness and volume differences between cognitive performance on neuropsychological tests of the group of individuals with dyslexia compared with a control group. This is a prospective study in which 30 children participated, with 15 individuals with dyslexia and 15 controls matched by age and sex. Cognitive skills were evaluated as such: Intellectual efficiency, attention skill, visuo- constructive abilities and skills of oral and written language. Brain morphometry was based on sequence T1 volumetric MRI automatic segmentation and measurement of the thickness and volume using FreeSurfer software package. Neuropsychological skills that were more impaired were aspects of memory and oral and written language, such as flattening of phonological working memory span and difficulty in verbal fluency, association and integration of ideas, definitions / concepts, appointment and especially phonological awareness, reading and writing. Neuroimaging studies suggest structural changes in the brain with clinical group reduction in gray matter volume in cortical regions such as the left inferior temporal lobe and right middle temporal lobe, and a reduction in the volume of white matter of both hemispheres. No significant changes were identified in thickness. Structural changes observed through imaging techniques may be related to cognitive functions that have proven affected.

Introdução: A crescente longevidade, realidade cada vez mais comum nas diversas sociedades convergem para as questões relativas à saúde, a qualidade de vida e bem-estar da população de idosos. Destaca-se ainda que a saúde desempenha um papel central no envelhecimento, podendo prever-se a qualidade de vida dos indivíduos idosos por esta variável. Apesar da condição de idoso não representar um risco enquanto tal é possível prever que um indivíduo mais velho sofrerá necessariamente perdas, uma vez que o envelhecimento pode se dar tanto por um processo natural (senescência) ou patológico (senilidade). OBJETIVO: verificar o impacto do treino de memória associado ao Neurotracker (NT) em idosos saudáveis. MÉTODO: amostra foi composta por 44 idosos a partir de 60 anos sem queixas cognitivas, foram randomizados em dois grupos: grupo experimental (GE=22) e o grupo controle (GC=22). Todos completaram 12 sessões de uma hora cada, duas vezes por semana, sendo que o GE realizou a mais 12 treinos com o NT. Para o treinamento da memória, foram utilizados estímulos computadorizados específicos associados a estratégias mnemônicas conscientemente aprendidas. Nos momentos pré e pós treino, amos os grupos foram avaliados através de questionário sócio-demográfico, avaliações neuropsicológicas, e escalas de autopercepção, além de uma medida com o NT. RESULTADOS: primeiramente, vale ressaltar a homogeneidade dos grupos em termos sociodemograficos, e em relação aos testes avaliados. Os resultados evidenciaram que ambos os grupos se beneficiaram com o treinamento de memória, contudo o GE obteve um resultado melhor em relação ao tempo de reação, velocidade de processamento visual, memória de trabalho e a percepção subjetiva da memória, validando a hipótese inicial levantada. O GE mostrou maior pontuação que o GC em testes consistentes com as estratégias treinadas, envolvendo recursos atencionais, memória de trabalho, episódica, semântica e subjetiva, pensamento associativo, velocidade de processamento e cognição social. Ambos os grupos reportaram sentimentos mais positivos quanto à própria memória e avaliaram positivamente as intervenções refletindo significativamente na qualidade de vida. Ademais, não foram observadas mudanças em sintomas de depressão. Em termos de duração, intensidade e frequência do treino, nota-se a necessidade de mais estudos com essa faixa da população. CONCLUSÃO: Os benefícios do TM associados ou não ao NT são evidentes e aparecem no resultado dos testes neuropsicológicos e das escalas. Além disto, após o TM, houve aumento no uso de estratégias associativas, maior confiança na própria memória e ganhos de qualidade de vida. Os dados corroboram os achados sugerindo que o cérebro de idosos permanece altamente plástico / INTRODUCTION: The increasing longevity, an increasingly common reality in different societies, converges to the issues related to health, quality of life and well-being of the elderly population. It is also worth noting that health plays a central role in aging, and the quality of life of elderly individuals can be predicted by this variable. Although the condition of the elderly does not pose a risk as such, it is possible to predict that an older individual will necessarily suffer losses, since aging may be due either to a natural (senescence) or pathological (senility) process. OBJECTIVE: to verify the impact of memory training associated with Neurotracker (NT) in healthy elderly. METHOD: The sample consisted of 44 elderly individuals aged 60 years old without cognitive complaints. They were randomized into two groups: experimental group (GE = 22) and control group (CG = 22). All completed 12 sessions of one hour each, twice a week, and the GE performed another 12 training sessions with the NT. For memory training, specific computer stimuli associated with consciously learned mnemonic strategies were used. In the pre- and post-training moments, the groups were evaluated through a socio-demographic questionnaire, neuropsychological assessments, and self-perception scales, as well as a measure with NT. RESULTS: First, it is worth mentioning the homogeneity of the groups in sociodemographic terms, and in relation to the tests evaluated. The results showed that both groups benefited from memory training, however the GE obtained a better result in relation to reaction time, visual processing speed, working memory and subjective memory perception, validating the initial hypothesis raised. The GE showed higher scores than the CG in tests consistent with the trained strategies, involving attention resources, work memory, episodic, semantic and subjective, associative thinking, processing speed and social cognition. Both groups reported more positive feelings about their own memory and positively assessed interventions that significantly reflected quality of life. In addition, no changes in symptoms of depression were observed. In terms of duration, intensity and frequency of training, it is noted the need for further studies with this range of the population. CONCLUSION: The benefits of TM associated or not to NT are evident and appear in the results of neuropsychological tests and scales. In addition, after TM, there was an increase in the use of associative strategies, greater confidence in the own memory and gains in quality of life. The data corroborate the findings suggesting that the brain of the elderly remains highly plastic