Hold test | |
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Purpose | for estimating premorbid intelligence in conditions as dementia, traumatic brain injury, and stroke |
Hold tests are neuropsychological tests which measure abilities which are thought to be largely resistant to cognitive decline following neurological damage. As a result, these tests are widely used for estimating premorbid intelligence in conditions such as dementia, traumatic brain injury, and stroke.
In neuropsychological assessment it is important to be able to accurately estimate premorbid intelligence. Accurate estimation allows the quantification of the impacts of neurological damage or decline, when compared to tests of current intelligence. The magnitude of decline is important for prognosis, rehabilitation planning and financial compensation. [1]
Hold tests typically measure crystallised intelligence, that is stored knowledge and skills, such as vocabulary and pronunciation. [2] Of course, hold tests of abilities directly affected by neurological damage are likely to underestimate intelligence. For example, using reading tests in patients with aphasia. Examples of hold tests used:
The use of hold tests is only one of a few possible methods of quantification of premorbid function. In practice a neuropsychologist may use a combination of methods to yield the most accurate estimate of premorbid intelligence. [2] Some of the other methods used are:
A review examined whether hold tests, best estimate or regression equation methods were most accurate in predicting overall IQ (full scale IQ) as determined by Wechsler Adult Intelligence Scale (WAIS-R) in a non-neurologically impaired population. It was found that different methods were more accurate depending on the IQ level of participants e.g. WRAT-3 (hold test) was most accurate for those of below average intelligence, NAART (hold test) was most accurate for those of average intelligence and the best estimate method was most accurate for above average intelligence. This provides support for the idea that no single method is superior in all cases and a combination of approaches is most appropriate in clinical practice. [5]
An intelligence quotient (IQ) is a total score derived from a set of standardized tests or subtests designed to assess human intelligence. The abbreviation "IQ" was coined by the psychologist William Stern for the German term Intelligenzquotient, his term for a scoring method for intelligence tests at University of Breslau he advocated in a 1912 book.
Neuropsychology is a branch of psychology. It is concerned with how a person's cognition and behavior are related to the brain and the rest of the nervous system. Professionals in this branch of psychology often focus on how injuries or illnesses of the brain affect cognitive and behavioral functions.
Neuropsychological tests are specifically designed tasks that are used to measure a psychological function known to be linked to a particular brain structure or pathway. Tests are used for research into brain function and in a clinical setting for the diagnosis of deficits. They usually involve the systematic administration of clearly defined procedures in a formal environment. Neuropsychological tests are typically administered to a single person working with an examiner in a quiet office environment, free from distractions. As such, it can be argued that neuropsychological tests at times offer an estimate of a person's peak level of cognitive performance. Neuropsychological tests are a core component of the process of conducting neuropsychological assessment, along with personal, interpersonal and contextual factors.
Clinical neuropsychology is a sub-field of psychology concerned with the applied science of brain-behaviour relationships. Clinical neuropsychologists use this knowledge in the assessment, diagnosis, treatment, and or rehabilitation of patients across the lifespan with neurological, medical, neurodevelopmental and psychiatric conditions, as well as other cognitive and learning disorders. The branch of neuropsychology associated with children and young people is pediatric neuropsychology.
Neuropsychological assessment was traditionally carried out to assess the extent of impairment to a particular skill and to attempt to determine the area of the brain which may have been damaged following brain injury or neurological illness. With the advent of neuroimaging techniques, location of space-occupying lesions can now be more accurately determined through this method, so the focus has now moved on to the assessment of cognition and behaviour, including examining the effects of any brain injury or neuropathological process that a person may have experienced.
The Wechsler Adult Intelligence Scale (WAIS) is an IQ test designed to measure intelligence and cognitive ability in adults and older adolescents. The original WAIS was published in February 1955 by David Wechsler, as a revision of the Wechsler–Bellevue Intelligence Scale, released in 1939. It is currently in its fourth edition (WAIS-IV) released in 2008 by Pearson, and is the most widely used IQ test, for both adults and older adolescents, in the world.
A block design test is a subtest on many IQ test batteries used as part of assessment of human intelligence. It is thought to tap spatial visualization ability and motor skill. The test-taker uses hand movements to rearrange blocks that have various color patterns on different sides to match a pattern. The items in a block design test can be scored both by accuracy in matching the pattern and by speed in completing each item.
Cognitive tests are assessments of the cognitive capabilities of humans and other animals. Tests administered to humans include various forms of IQ tests; those administered to animals include the mirror test and the T maze test. Such study is important to research concerning the philosophy of mind and psychology, as well as determination of human and animal intelligence.
The Wechsler Intelligence Scale for Children (WISC) is an individually administered intelligence test for children between the ages of 6 and 16. The Fifth Edition is the most recent version.
Alan S. Kaufman is an American psychologist and writer known for his work on intelligence testing.
Edith F. Kaplan was an American psychologist. She was a pioneer of neuropsychological tests and did most of her work at the Boston VA Hospital. Kaplan is known for her promotion of clinical neuropsychology as a specialty area in psychology. She examined brain-behavioral relationships in aphasia, apraxia, developmental issues in clinical neuropsychology, as well as normal and abnormal aging. Kaplan helped develop a new method of assessing brain function with neuropsychological assessment, called "The Boston Process Approach."
The Wechsler Preschool and Primary Scale of Intelligence (WPPSI) is an intelligence test designed for children ages 2 years 6 months to 7 years 7 months developed by David Wechsler in 1967. It is a descendant of the earlier Wechsler Adult Intelligence Scale and the Wechsler Intelligence Scale for Children tests. Since its original publication the WPPSI has been revised three times in 1989, 2002, and 2012. The current version, WPPSI–IV, published by Pearson Education, is a revision of the WPPSI-R and the WPPSI-III. It provides subtest and composite scores that represent intellectual functioning in verbal and performance cognitive domains, as well as providing a composite score that represents a child’s general intellectual ability.
The Kaufman Assessment Battery for Children (KABC) is a clinical instrument for assessing cognitive development. Its construction incorporates several recent developments in both psychological theory and statistical methodology. The test was developed by Alan S. Kaufman and Nadeen L. Kaufman in 1983 and revised in 2004. The test has been translated and adopted for many countries, such as the Japanese version of the K-ABC by the Japanese psychologists Tatsuya Matsubara, Kazuhiro Fujita, Hisao Maekawa, and Toshinori Ishikuma.
IQ classification is the practice by IQ test publishers of labeling IQ score ranges with category names such as "superior" or "average".
The National Adult Reading Test (NART) is a widely accepted and commonly used method in clinical settings for estimating premorbid intelligence levels of English-speaking patients with dementia in neuropsychological research and practice. Such tests are called hold tests as these abilities are thought to be spared, or "held" following neurological injury or decline. The NART was developed by Hazel Nelson in the 1980s in Britain and published in 1982. The test comprises 50 written words in British English which all have irregular spellings, so as to test the participant's vocabulary rather than their ability to apply regular pronunciation rules. The manual includes equations for converting NART scores to predicted IQ scores on the Wechsler Adult Intelligence Scale.
The Halstead-Reitan Neuropsychological Test Battery (HRNB) and allied procedures is a comprehensive suite of neuropsychological tests used to assess the condition and functioning of the brain, including etiology, type, localization and lateralization of brain injury. The HRNB was first constructed by Ward C. Halstead, who was chairman of the Psychology Department at the University of Chicago, together with his doctoral student, Ralph Reitan. A major aim of administering the HRNB to patients was if possible to lateralize a lesion to either the left or right cerebral hemisphere by comparing the functioning on both sides of the body on a variety of tests such as the Suppression or Sensory Imperception Test, the Finger Agnosia Test, Finger Tip Writing, the Finger Tapping Test, and the Tactual Performance Test. One difficulty with the HRNB was its excessive administration time. In particular, administration of the Halstead Category Test was lengthy, so subsequent attempts were made to construct reliable and valid short-forms.
The Wechsler Test of Adult Reading (WTAR) is a neuropsychological assessment tool used to provide a measure of premorbid intelligence, the degree of Intellectual function prior to the onset of illness or disease.
The Boston Process Approach is a neurological assessment tool developed by Edith Kaplan and her colleagues, Harold Goodglass, Nelson Butters, Laird Cermak, and Norman Geschwind at the Boston Veterans Medical Center. The main purpose of the Boston Process Approach is to assess brain damage as well as cognitive impairments in patients through a series of tests that are related to memory, attention, intelligence, and other aspects of information processing. This approach is one of the more flexible and qualitative neurological assessments because it emphasizes how a patient performs a task instead of whether they succeeded or failed at it.
Ralph M. Reitan was an American neuropsychologist and one of the fathers of American clinical neuropsychology having brought the notion of brain-behavior relationships to the forefront of the field. He is best known for his role in developing the Halstead-Reitan Neuropsychological Battery and his strong belief in empiricism and evidence-based practice. He was a strong advocate of use of a fixed battery in neuropsychological assessment, published prolifically, and mentored many students who also became prominent in the field. As an author, he has been collected by libraries.
The Wide Range Intelligence test (WRIT) is an assessment of verbal (crystallized) and visual (fluid) IQ. Running at approximately 30 minutes, the WRIT is shorter than traditional IQ tests. The test also involves only four subtests and requires fewer physical materials than a typical test. It was created alongside the Wide Range Achievement Test 3 (WRAT3), a measure of reading comprehension and academic ability, by Pearson Education in 2000. The WRIT is intended to assess those aged 4 through 85. It is designed for easy administration among trained psychologists, which is accomplished using a hierarchical model that frequently occurs in psychological testing.
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