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Neuropsychological Assessment of Recovery after Mild Traumatic Brain InjuryKarleigh Kwapil Unknown Date (has links)
Mild Traumatic Brain injury (mTBI) is one of the most common forms of acquired neurological damage. However, the term 'mild' TBI is misleading because the physical, cognitive and emotional impairments that can follow from mTBI can be significant. In order to provide objective, prognostic measures for diagnosing the severity of mTBI and identifying individuals who may be at risk for poor outcomes a battery of neuropsychological measures for detecting cognitive impairment was evaluated. The Rapid Screen of Concussion (RSC) is a collection of tests assessing verbal recall, orientation, processing speed and speed of language comprehension. Previous studies have demonstrated that the RSC has acceptable reliability, validity and sensitivity to cognitive impairment that arises during the acute stages of injury. However, no studies have investigated the predictive validity of this instrument. Moreover it is unclear what additional patient or post injury variables could assist in identifying those individuals who may be at risk of poor neuropsychological outcomes following mTBI. These were among the main issues that were addressed across the five empirical studies in this thesis. A pragmatic, prospective, longitudinal and cross-sectional study of the sequelae of mTBI in patients presenting to the Department of Emergency Medicine of the Royal Brisbane and Women's hospital was the basis of this project. The first empirical chapter (chapter 2), examined the psychometric properties of two measures of verbal learning and memory and investigated their potential for discriminating between mTBI and orthopaedic controls. The performance of 93 patients with mTBI and 68 participants with orthopaedic injuries was analysed to identify the number of individuals who performed at ceiling on the Hopkins Verbal Learning test (HVLT-R) versus a 5-word test of immediate and delayed recall. While both of these verbal recall measures were effective in separating the mTBI and orthopaedic groups, overall, the HVLT-R was shown to be a more suitable measure for screening for deficits in verbal learning and memory after mTBI. Given the superiority of the HVLT-R as a measure of verbal learning and memory, chapter 3 aimed to examine whether inclusion of this test could improve the sensitivity of the RSC in mTBI compared to orthopaedic and uninjured control samples. Results were generally within the direction predicted. Significant differences were found between groups on the majority of cognitive indices assessed. Both the orthopaedic and mTBI group performed more poorly than the uninjured group on all measures except the Hopkins delayed recognition. Additional performance decrements shown by the mTBI group compared to the orthopaedic group illustrate that factors beyond the general effects of trauma influence performance and may be related to cognitive impairment specific to sustaining mTBI. Overall it was concluded that the revised RSC is a sensitive instrument deserving investigation in assessing the more long term cognitive effects following mTBI. Chapter 4 applied this sensitive battery for investigation of group and individual recovery of neuropsychological test performance and post-concussive symptom reporting up to 3-months after mTBI. A sample of 30 mTBI participants and 30 uninjured controls were serially assessed on cognitive measures and symptom report scales immediately after injury and after 1-week, 1-month and 3-months. Symptom reporting on the Rivermead post-concussive inventory separated the mTBI and control groups after 1-week but diagnostic accuracy was no greater than chance at 1 and 3-months. In contrast the mTBI group performed more poorly than controls on measures on neuropsychological measures acutely, at 1-week and 1-month, with group differences still evident after 3-months. Nonethless, a trend of progressive recovery over time was seen in the mTBI group. In chapter 5, criteria utilising the concepts of reliable and statistically significant change were applied to the data. Overall, 73% of mTBI patients were impaired on one or more tests acutely. Significant recovery was demonstrated by 20% of mTBI participants by 3-months; however recovery remained incomplete for half of the mTBI participants by 3-months. These results highlighted the importance of an individual approach to the assessment of mTBI and support the notion that a proportion of mTBI cases may have protracted difficulties. Chapter 6 extended these findings by showing that the RSC has prognostic ability. It was found that acute neuropsychological performance on the RSC was a significant predictor of performance on an extended battery at 3-months. The final chapter provides a general discussion and synthesis of the findings. In summary, the present dissertation demonstrated that inclusion of a sensitive measure of verbal recall led to improved diagnostic validity of the RSC. Neuropsychological measures rather than symptom reporting were sensitive in detecting cognitive impairment at 3-months. Analysis of individuals showed that up to 50% of the group had failed to – demonstrate reliable recovery – that is, make improvements over and above practice effects after 3-months. Finally, acute neuropsychological performance was predictive of long term performance. Overall, the present thesis has identified a short battery of tests that is suitable for assessment of mTBI within 24 hours and may assist in identifying individuals at risk of poor cognitive outcomes after mTBI.
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Neuropsychological Assessment of Recovery after Mild Traumatic Brain InjuryKarleigh Kwapil Unknown Date (has links)
Mild Traumatic Brain injury (mTBI) is one of the most common forms of acquired neurological damage. However, the term 'mild' TBI is misleading because the physical, cognitive and emotional impairments that can follow from mTBI can be significant. In order to provide objective, prognostic measures for diagnosing the severity of mTBI and identifying individuals who may be at risk for poor outcomes a battery of neuropsychological measures for detecting cognitive impairment was evaluated. The Rapid Screen of Concussion (RSC) is a collection of tests assessing verbal recall, orientation, processing speed and speed of language comprehension. Previous studies have demonstrated that the RSC has acceptable reliability, validity and sensitivity to cognitive impairment that arises during the acute stages of injury. However, no studies have investigated the predictive validity of this instrument. Moreover it is unclear what additional patient or post injury variables could assist in identifying those individuals who may be at risk of poor neuropsychological outcomes following mTBI. These were among the main issues that were addressed across the five empirical studies in this thesis. A pragmatic, prospective, longitudinal and cross-sectional study of the sequelae of mTBI in patients presenting to the Department of Emergency Medicine of the Royal Brisbane and Women's hospital was the basis of this project. The first empirical chapter (chapter 2), examined the psychometric properties of two measures of verbal learning and memory and investigated their potential for discriminating between mTBI and orthopaedic controls. The performance of 93 patients with mTBI and 68 participants with orthopaedic injuries was analysed to identify the number of individuals who performed at ceiling on the Hopkins Verbal Learning test (HVLT-R) versus a 5-word test of immediate and delayed recall. While both of these verbal recall measures were effective in separating the mTBI and orthopaedic groups, overall, the HVLT-R was shown to be a more suitable measure for screening for deficits in verbal learning and memory after mTBI. Given the superiority of the HVLT-R as a measure of verbal learning and memory, chapter 3 aimed to examine whether inclusion of this test could improve the sensitivity of the RSC in mTBI compared to orthopaedic and uninjured control samples. Results were generally within the direction predicted. Significant differences were found between groups on the majority of cognitive indices assessed. Both the orthopaedic and mTBI group performed more poorly than the uninjured group on all measures except the Hopkins delayed recognition. Additional performance decrements shown by the mTBI group compared to the orthopaedic group illustrate that factors beyond the general effects of trauma influence performance and may be related to cognitive impairment specific to sustaining mTBI. Overall it was concluded that the revised RSC is a sensitive instrument deserving investigation in assessing the more long term cognitive effects following mTBI. Chapter 4 applied this sensitive battery for investigation of group and individual recovery of neuropsychological test performance and post-concussive symptom reporting up to 3-months after mTBI. A sample of 30 mTBI participants and 30 uninjured controls were serially assessed on cognitive measures and symptom report scales immediately after injury and after 1-week, 1-month and 3-months. Symptom reporting on the Rivermead post-concussive inventory separated the mTBI and control groups after 1-week but diagnostic accuracy was no greater than chance at 1 and 3-months. In contrast the mTBI group performed more poorly than controls on measures on neuropsychological measures acutely, at 1-week and 1-month, with group differences still evident after 3-months. Nonethless, a trend of progressive recovery over time was seen in the mTBI group. In chapter 5, criteria utilising the concepts of reliable and statistically significant change were applied to the data. Overall, 73% of mTBI patients were impaired on one or more tests acutely. Significant recovery was demonstrated by 20% of mTBI participants by 3-months; however recovery remained incomplete for half of the mTBI participants by 3-months. These results highlighted the importance of an individual approach to the assessment of mTBI and support the notion that a proportion of mTBI cases may have protracted difficulties. Chapter 6 extended these findings by showing that the RSC has prognostic ability. It was found that acute neuropsychological performance on the RSC was a significant predictor of performance on an extended battery at 3-months. The final chapter provides a general discussion and synthesis of the findings. In summary, the present dissertation demonstrated that inclusion of a sensitive measure of verbal recall led to improved diagnostic validity of the RSC. Neuropsychological measures rather than symptom reporting were sensitive in detecting cognitive impairment at 3-months. Analysis of individuals showed that up to 50% of the group had failed to – demonstrate reliable recovery – that is, make improvements over and above practice effects after 3-months. Finally, acute neuropsychological performance was predictive of long term performance. Overall, the present thesis has identified a short battery of tests that is suitable for assessment of mTBI within 24 hours and may assist in identifying individuals at risk of poor cognitive outcomes after mTBI.
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Neuropsychological Assessment of Recovery after Mild Traumatic Brain InjuryKarleigh Kwapil Unknown Date (has links)
Mild Traumatic Brain injury (mTBI) is one of the most common forms of acquired neurological damage. However, the term 'mild' TBI is misleading because the physical, cognitive and emotional impairments that can follow from mTBI can be significant. In order to provide objective, prognostic measures for diagnosing the severity of mTBI and identifying individuals who may be at risk for poor outcomes a battery of neuropsychological measures for detecting cognitive impairment was evaluated. The Rapid Screen of Concussion (RSC) is a collection of tests assessing verbal recall, orientation, processing speed and speed of language comprehension. Previous studies have demonstrated that the RSC has acceptable reliability, validity and sensitivity to cognitive impairment that arises during the acute stages of injury. However, no studies have investigated the predictive validity of this instrument. Moreover it is unclear what additional patient or post injury variables could assist in identifying those individuals who may be at risk of poor neuropsychological outcomes following mTBI. These were among the main issues that were addressed across the five empirical studies in this thesis. A pragmatic, prospective, longitudinal and cross-sectional study of the sequelae of mTBI in patients presenting to the Department of Emergency Medicine of the Royal Brisbane and Women's hospital was the basis of this project. The first empirical chapter (chapter 2), examined the psychometric properties of two measures of verbal learning and memory and investigated their potential for discriminating between mTBI and orthopaedic controls. The performance of 93 patients with mTBI and 68 participants with orthopaedic injuries was analysed to identify the number of individuals who performed at ceiling on the Hopkins Verbal Learning test (HVLT-R) versus a 5-word test of immediate and delayed recall. While both of these verbal recall measures were effective in separating the mTBI and orthopaedic groups, overall, the HVLT-R was shown to be a more suitable measure for screening for deficits in verbal learning and memory after mTBI. Given the superiority of the HVLT-R as a measure of verbal learning and memory, chapter 3 aimed to examine whether inclusion of this test could improve the sensitivity of the RSC in mTBI compared to orthopaedic and uninjured control samples. Results were generally within the direction predicted. Significant differences were found between groups on the majority of cognitive indices assessed. Both the orthopaedic and mTBI group performed more poorly than the uninjured group on all measures except the Hopkins delayed recognition. Additional performance decrements shown by the mTBI group compared to the orthopaedic group illustrate that factors beyond the general effects of trauma influence performance and may be related to cognitive impairment specific to sustaining mTBI. Overall it was concluded that the revised RSC is a sensitive instrument deserving investigation in assessing the more long term cognitive effects following mTBI. Chapter 4 applied this sensitive battery for investigation of group and individual recovery of neuropsychological test performance and post-concussive symptom reporting up to 3-months after mTBI. A sample of 30 mTBI participants and 30 uninjured controls were serially assessed on cognitive measures and symptom report scales immediately after injury and after 1-week, 1-month and 3-months. Symptom reporting on the Rivermead post-concussive inventory separated the mTBI and control groups after 1-week but diagnostic accuracy was no greater than chance at 1 and 3-months. In contrast the mTBI group performed more poorly than controls on measures on neuropsychological measures acutely, at 1-week and 1-month, with group differences still evident after 3-months. Nonethless, a trend of progressive recovery over time was seen in the mTBI group. In chapter 5, criteria utilising the concepts of reliable and statistically significant change were applied to the data. Overall, 73% of mTBI patients were impaired on one or more tests acutely. Significant recovery was demonstrated by 20% of mTBI participants by 3-months; however recovery remained incomplete for half of the mTBI participants by 3-months. These results highlighted the importance of an individual approach to the assessment of mTBI and support the notion that a proportion of mTBI cases may have protracted difficulties. Chapter 6 extended these findings by showing that the RSC has prognostic ability. It was found that acute neuropsychological performance on the RSC was a significant predictor of performance on an extended battery at 3-months. The final chapter provides a general discussion and synthesis of the findings. In summary, the present dissertation demonstrated that inclusion of a sensitive measure of verbal recall led to improved diagnostic validity of the RSC. Neuropsychological measures rather than symptom reporting were sensitive in detecting cognitive impairment at 3-months. Analysis of individuals showed that up to 50% of the group had failed to – demonstrate reliable recovery – that is, make improvements over and above practice effects after 3-months. Finally, acute neuropsychological performance was predictive of long term performance. Overall, the present thesis has identified a short battery of tests that is suitable for assessment of mTBI within 24 hours and may assist in identifying individuals at risk of poor cognitive outcomes after mTBI.
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Neuropsychological Assessment of Recovery after Mild Traumatic Brain InjuryKarleigh Kwapil Unknown Date (has links)
Mild Traumatic Brain injury (mTBI) is one of the most common forms of acquired neurological damage. However, the term 'mild' TBI is misleading because the physical, cognitive and emotional impairments that can follow from mTBI can be significant. In order to provide objective, prognostic measures for diagnosing the severity of mTBI and identifying individuals who may be at risk for poor outcomes a battery of neuropsychological measures for detecting cognitive impairment was evaluated. The Rapid Screen of Concussion (RSC) is a collection of tests assessing verbal recall, orientation, processing speed and speed of language comprehension. Previous studies have demonstrated that the RSC has acceptable reliability, validity and sensitivity to cognitive impairment that arises during the acute stages of injury. However, no studies have investigated the predictive validity of this instrument. Moreover it is unclear what additional patient or post injury variables could assist in identifying those individuals who may be at risk of poor neuropsychological outcomes following mTBI. These were among the main issues that were addressed across the five empirical studies in this thesis. A pragmatic, prospective, longitudinal and cross-sectional study of the sequelae of mTBI in patients presenting to the Department of Emergency Medicine of the Royal Brisbane and Women's hospital was the basis of this project. The first empirical chapter (chapter 2), examined the psychometric properties of two measures of verbal learning and memory and investigated their potential for discriminating between mTBI and orthopaedic controls. The performance of 93 patients with mTBI and 68 participants with orthopaedic injuries was analysed to identify the number of individuals who performed at ceiling on the Hopkins Verbal Learning test (HVLT-R) versus a 5-word test of immediate and delayed recall. While both of these verbal recall measures were effective in separating the mTBI and orthopaedic groups, overall, the HVLT-R was shown to be a more suitable measure for screening for deficits in verbal learning and memory after mTBI. Given the superiority of the HVLT-R as a measure of verbal learning and memory, chapter 3 aimed to examine whether inclusion of this test could improve the sensitivity of the RSC in mTBI compared to orthopaedic and uninjured control samples. Results were generally within the direction predicted. Significant differences were found between groups on the majority of cognitive indices assessed. Both the orthopaedic and mTBI group performed more poorly than the uninjured group on all measures except the Hopkins delayed recognition. Additional performance decrements shown by the mTBI group compared to the orthopaedic group illustrate that factors beyond the general effects of trauma influence performance and may be related to cognitive impairment specific to sustaining mTBI. Overall it was concluded that the revised RSC is a sensitive instrument deserving investigation in assessing the more long term cognitive effects following mTBI. Chapter 4 applied this sensitive battery for investigation of group and individual recovery of neuropsychological test performance and post-concussive symptom reporting up to 3-months after mTBI. A sample of 30 mTBI participants and 30 uninjured controls were serially assessed on cognitive measures and symptom report scales immediately after injury and after 1-week, 1-month and 3-months. Symptom reporting on the Rivermead post-concussive inventory separated the mTBI and control groups after 1-week but diagnostic accuracy was no greater than chance at 1 and 3-months. In contrast the mTBI group performed more poorly than controls on measures on neuropsychological measures acutely, at 1-week and 1-month, with group differences still evident after 3-months. Nonethless, a trend of progressive recovery over time was seen in the mTBI group. In chapter 5, criteria utilising the concepts of reliable and statistically significant change were applied to the data. Overall, 73% of mTBI patients were impaired on one or more tests acutely. Significant recovery was demonstrated by 20% of mTBI participants by 3-months; however recovery remained incomplete for half of the mTBI participants by 3-months. These results highlighted the importance of an individual approach to the assessment of mTBI and support the notion that a proportion of mTBI cases may have protracted difficulties. Chapter 6 extended these findings by showing that the RSC has prognostic ability. It was found that acute neuropsychological performance on the RSC was a significant predictor of performance on an extended battery at 3-months. The final chapter provides a general discussion and synthesis of the findings. In summary, the present dissertation demonstrated that inclusion of a sensitive measure of verbal recall led to improved diagnostic validity of the RSC. Neuropsychological measures rather than symptom reporting were sensitive in detecting cognitive impairment at 3-months. Analysis of individuals showed that up to 50% of the group had failed to – demonstrate reliable recovery – that is, make improvements over and above practice effects after 3-months. Finally, acute neuropsychological performance was predictive of long term performance. Overall, the present thesis has identified a short battery of tests that is suitable for assessment of mTBI within 24 hours and may assist in identifying individuals at risk of poor cognitive outcomes after mTBI.
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A Comprehensive Neuropsychological Screening Device for Adults: Reliability of Parallel FormsGanci, Maria 12 1900 (has links)
The purpose of the present study was to evaluate the reliability of parallel-forms of the Comprehensive Neuropsychological Screening Device (CNS). Forty-five subjects ranging in age from 16 to 69 were administered Form A and Form B of the CNS at two week intervals. Results indicated that the CNS has adequate test-retest reliability. The results suggest the applicability of using the CNS as a screening device for brain dysfunction.
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Assessment of Brain Damage: Discriminant Validity of a Neuropsychological Key Approach with the McCarron-Dial SystemNorton, Carole Lynn 12 1900 (has links)
The present study investigates the predictive accuracy of a key approach to interpretation of the verbal-spatialcognitive (VSC) and sensorimotor (SM) factors of the McCarron-Dial System (MDS). The subjects include 99 brain damaged and 30 normal adults. The following research questions are addressed: (a) Does the neuropsychological key classify brain damaged and non-brain damaged subjects at a level significantly above chance? (b) Among the brain damaged subjects, does the neuropsychological key identify right brain damage, left brain damage and diffuse brain damage at an accuracy level significantly above chance? (c) Is the neuropsychological key approach superior to the empirical model derived from discriminant function analysis in predictive accuracy? The neuropsychological key correctly classifies 90% of the cases as brain damaged and 90% of the cases as non-brain damaged, for a total of 89.9% predictive accuracy. The obtained Kappa coefficient of .74 is statistically significant. The key accurately classifies 71.4% of the brain damaged group as right damage, 70% as left damage, and 93.8% as diffuse damage, for a total predictive accuracy of 7 9.5%. The Kappa coefficient of .68 is statistically significant. Chi square analysis of the difference between the key approach and multiple discriminant function analysis reveals that no significant difference is present between the accuracy of the two approaches in differentiating between brain damaged and non-brain damaged, or in differentiating among left, right and diffuse brain damage. The results support the validity of a neuropsychological key approach to interpretation of the McCarron-Dial System, although cross-validation is indicated to confirm the stability of these results. Differences in sex, educational level and racial composition of the comparison groups may have affected the results obtained. Refinement of the key in future research and the addition of test instruments assessing memory, auditory processing, attention and emotional/behavioral variables are recommended.
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NEPSY profiles in children diagnosed with different ADHD subtypes.Couvadelli, Barbara 12 1900 (has links)
The purpose of this study was to determine if attention-deficit/hyperactivity disorder (ADHD) subtypes (predominantly hyperactive/impulsive, ADHD-HI; predominantly inattentive, ADHD-IA; combined, ADHD-C) exhibit distinct neuropsychological profiles, using the Attention and Executive Function subtests of the Developmental Neuropsychological Assessment, (NEPSY) and the omission and commission scores obtained on the Conners' Continuous Performance Test-II (CPT-II), a test that assesses attention processes. The sample was selected using archival data collected in a neurodevelopmental clinic over the past decade and consisted of 138 children between the ages of 6 and 12 years old. Using the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV) criteria, the children were placed in either the ADHD-HI (n = 40), ADHD-IA (n = 35), or ADHD-C (n = 36) group, or a symptom free comparison group (n = 27). It was hypothesized that children with elevations on the impulsivity/ hyperactivity (ADHD-HI and ADHD-C) scale would be impaired on measures of inhibition and those with elevations on the inattention scale (ADHD-IA and ADHD-C) would be impaired on tests of attention, vigilance, and other executive functions. A one-way multivariate analyses of variance (MANOVA) was conducted (Group X Task), with significant results for overall main effect for group on the 7 dependent variables post hoc tests using the Tukey's honestly significant difference (HSD) revealed the following: the ADHD-HI group scored significantly lower on tests that require behavioral inhibition processes (Knock and Tap, Statue and CPT-Commission errors). The ADHD-IA group scored significantly lower on tests of problem-solving and planning (Tower) but not on tests of attention as was expected. The ADHD-C group scored significantly lower on tests of inhibition, attention, and other executive functions (Auditory Attention Response Set, Visual Attention, Tower, Knock and Tap, Statue, and CPT-Omission and CPT-Commission errors). Overall results suggest that the NEPSY Attention and Executive Function subtests are able to differentiate ADHD subtypes. Recommendations for future research are discussed.
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Validation of a rating scale for bedside cognitive assessmentRoos, Annerine 04 1900 (has links)
Thesis (MMed)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Numerous tests exist for the assessment of general cognitive functioning. Most of these tests
were developed within the discipline of psychology. Neuropsychological tests are very useful,
but have some limitations. Administration of the tests is limited to a psychologist, is very timeconsuming
in that it can take 3-8 hours to administer and often need specialized equipment.
At the other end of the continuum are very brief screening tests. General practitioners,
psychiatrists and occupational therapists, in addition to psychologists, also use these tests.
Although useful, the short tests only provide limited information. An intermediate level test
streamlining the assessment process between the very short and longer neuropsychological
tests is therefore introduced by this study.
The Bedside Cognitive Assessment Battery (BCAB) was developed in 1995 and are since
used, at Tygerberg Hospital's Memory Clinic, to assess patients and teach students. The test
comprehensively assesses the six main classes of cognitive functioning, namely attention
and concentration, speech, memory, motor functioning, perceptual functioning and executive
functioning. Approximately 35-45 minutes is required for administration and training is
needed to administer the BCAB. No specialized equipment is needed for administration. The
battery can therefore be used at the bedside, in the office or at old age homes.
The aims of this study were to validate the BCAB for use with people aged eighteen years
and older, and provide normative values for use in clinical settings. The test was revised in
1997 and 2001, and extensively so in 2002, but was never formally evaluated for validity.
Well-known single tests were used to compile the BCAB. Most of these tests have proven
validity and reliability, but only for foreign populations. In addition, some items were
reformulated and others created by the researchers. The introduction of normative values
would also be useful to assist in the delineation of cognitively intact and impaired individuals.
This study succeeded in providing a table of normative values.
One-hundred-and-sixty Afrikaans and English participants, and fourteen Xhosa participants
were assessed in their mother tongue language. This project thus also introduced a Xhosa
version of the BCAB. The purpose of the Xhosa version was to address the lack of culturally
relevant cognitive assessment instruments. Results were evaluated for the effects of the
variables' language, gender, age and education. The effect of language was most noticeable
in the Xhosa group. Gender did not affect results as dramatically as age and especially,
education. These significant effects on the aforementioned variables have been described in previous reports. The BCAB is thus relevant and useful as a detector of mild to moderate
impairment. It can also be used to identify specific impairment. This can narrow down the
investigation of psychologists, thus saving time and money. In addition, medical and nonmedical
staff can use the BCAB.
Some limitations were also identified. The sample used may limit the generalization of
results. Some test items also need revision, along with further validation studies. Clinicians
are therefore advised to use the BCAB only in addition to complete clinical examinations
when making decisions regarding a patient's cognitive status. The BCAB appears to be a
valid tool for bedside assessment. However, this study could only set the stage for further
research, especially studies concerned with establishing normative values. / AFRIKAANSE OPSOMMING: Verskeie toetse bestaan vir die evaluering van algemene kognitiewe funksionering, waarvan
die meeste ontwikkel is binne die sielkunde. Neuro-sielkundige toetse is baie bruikbaar, maar
het sekere beperkings. Administrasie van die toetse is beperk tot sielkundiges, maar
tydrowend weens 'n tydsduur van drie tot agt uur, en verg dikwels gespesialiseerde
toerusting. Aan die ander kant is heelwat kart siftings-toetse beskikbaar. Aigemene
praktisyns, sielkundiges en arbeidsterapeute, asook sielkundiges, gebruik dit. Hoewel
bruikbaar, bied die kart toetse beperkte inligting. 'n lntermediere vlak toets om die
evaluerings-proses tussen kart en langer neuro-sielkundige toetse te integreer word met
hierdie studie beoog.
Die Bedkant Kognitiewe Evaluasie Battery (BKEB) is in 1995 ontwikkel en gebruik in die
Geheue-kliniek van die Tygerberg Hospitaal om pasiente te evalueer en studente op te lei.
Die toets is gerig op die omvattende evaluering van die ses hoof-klasse van kognitiewe
funksionering. Hierdie klasse omvat aandag en konsentrasie, spraak, geheue, motoriese
funksionering, perseptuele funksionering en uitvoerende funksionering. Sowat 35 tot 45
minute word benodig vir administrasie terwyl opleiding vereis word vir die neem van die
toets. Geen gespesialiseerde toerusting is nodig nie. Die battery kan dus by die bedkant, in
die kantoor of in ouetehuise gebruik word.
Die doelwitte van hierdie studie is om die BKEB te evalueer in gebruik by 18-jariges en ouer,
en normatiewe waardes te bepaal vir gebruik in kliniese omgewings. Die toets is in 1997 en
2001 hersien. In 2002 is dit uitvoerig hersien, maar nooit ge-evalueer vir geldigheid nie.
Bekende enkel-toetse is gebruik am die BKEB saam te stel. Dit is as geldig en betroubaar
bewys, hoewel slegs onder buitelandse bevolkingsgroepe. Hierbenewens is sekere items
herformuleer en ander bygewerk deur die navorsers. Normatiewe waardes sal oak handig
wees in die afbakening van kognitief normaal-funksionerende en kognitief-ingekorte
individue. Hierdie studie het daarin geslaag am 'n tabel van normatiewe waardes daar te stel.
Een-honderd-en-sestig Afrikaans- en Engels-sprekendes, en 14 Xhosa-sprekendes is tydens
hierdie studie in hulle moedertaal ge-evalueer. Hierdie projek het dus oak 'n Xhosaweergawe
van die BKEB geskep. Die doel van die Xhosa-weergawe was am die gebrek aan
'n kultureel toepaslike kognitiewe instrument te beklemtoon. Resultate is ge-evalueer
gedagtig aan veranderlikes soos taal, geslag, ouderdom en opleidingsvlak. Taal het die
grootste invloed gehad op uitslae van Xhosa-deelnemers. Geslag het nie die uitslae so dramaties bernvloed soos ouderdom, en veral opleidingsvlak nie. Literatuur het meestal die
groot uitwerking van hierdie veranderlikes bevestig. Die BKEB is dus relevant en handig in
die naspeuring van ligte tot matige kognitiewe ingekortheid. Dit kan ook gebruik word om
spesifieke kognitiewe ingekortheid te identifiseer. Die kan die omvang van ondersoek deur
sielkundiges vernou, wat kan lei tot In groot besparing in tyd en geld. Hierbenewens kan
mediese en nie-mediese personeel aangewend word in die gebruik van die BKEB.
Sekere tekortkominge is ge·,dentifiseer. Die steekproef mag egter die veralgemening van die
uitslae beperk. Sekere toets-items mag ook hersiening vereis, tesame met verdere
geldigheid-studies. Kliniese praktisyns word daarom aangeraai om die BKEB slegs in
aanvulling tot omvattende kliniese ondersoeke te gebruik vir besluite m.b.t. In pasient se
kognitiewe status. Die BKEB kom voor as In geldige instrument vir bedkant evaluering.
Hierdie studie kon egter slegs die tafel dek vir verdere ondersoek, veral t.o.v. studies wat
poog om normatiewe waardes daar te stel.
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Longitudinal neurocognitive functions in First-episode psychosis: 24-month follow-upTso, F., 曹斐. January 2002 (has links)
published_or_final_version / Psychiatry / Master / Master of Philosophy
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Child and parent experiences of neuropsychological assessment as a function of child-centered feedbackPilgrim, Shea McNeill 26 October 2010 (has links)
Research has paid little attention to clients’ experience of the psychological assessment process, particularly in regard to the experiences of children and their parents. Advocates of collaborative assessment have long espoused the therapeutic benefits of providing feedback that can help clients better understand themselves and improve their
lives (Finn & Tonsager, 1992; Fischer, 1970, 1985/1994). Finn, Tharinger, and colleagues (2007; 2009) have extended a semi-structured form of collaborative assessment, Therapeutic Assessment (TA), with children. One important aspect of their method, drawn from Fischer’s (1985/1994) example, is the creation of individualized fables that incorporate assessment findings into a child-friendly format. The fables are then shared with the child and parents as assessment feedback. This study evaluated whether receiving this type of individualized, developmentally appropriate feedback would affect how children and their parents report experiencing the assessment process. The assessment process, with the exception of child feedback, was standard for the
setting. Participants were 32 children who underwent a neuropsychological evaluation at
a private outpatient clinic, along with their parents. Multivariate and univariate statistics
were used to test differences between two groups: an experimental group that received
individualized fables as child-focused feedback and a control group. Children in the
experimental group reported a greater sense of learning about themselves, a more positive
relationship with their assessor, a greater sense of collaboration with the assessment process, and a sense that their parents learned more about them because of the assessment than did children in the control group. Parents in the experimental group reported a more
positive relationship between their child and the assessor, a greater sense of collaboration
with the assessment process, and higher satisfaction with clinic services compared to the
control group. Limitations to the study, implications for assessment practice with children, and future directions for research are discussed. / text
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