Tower of London test | |
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Purpose | assess executive function |
The Tower of London test is a test used in applied clinical neuropsychology for the assessment of executive functioning specifically to detect deficits in planning, [1] [2] which may occur due to a variety of medical and neuropsychiatric conditions. It is related to the classic problem-solving puzzle known as the Tower of Hanoi.
The test was developed by the psychologist Tim Shallice
The test consists of two boards with pegs and several beads with different colors. The examiner (usually a clinical psychologist or a neuropsychologist) presents the examinee with problem-solving tasks: one board shows the goal arrangement of beads, and the other board is given to the examinee with the beads in a different configuration. By moving beads from one peg to another, the examinee must alter the second board to match the first - a task that requires a degree of thinking ahead. [3]
One common use of the test is for diagnosis of executive impairment. The performance of the examinee is compared to representative samples of individuals of the same age to derive hypotheses about the person's executive cognitive ability, especially as it may relate to brain damage. A certain degree of controversy surrounds the test's construct validity. [4]
Several variants of the test exist. Shallice's original test used three beads and pegs with different heights, although later researchers have generalized this to more beads without a peg height restriction. [5] Versions of the test are available from a number of sources, including a stand-alone test by William Culbertson and Eric Zillmer (published by Drexel University) and a child/adolescent version that is part of the original NEPSY neuropsychological battery of tests by Marit Korkman, Ursula Kirk, and Sally Kemp (although removed from the second edition). A computerised variant, known as the Stockings of Cambridge test, is available as part of the Cambridge Neuropsychological Test Automated Battery (CANTAB).
Rehabilitation of sensory and cognitive function typically involves methods for retraining neural pathways or training new neural pathways to regain or improve neurocognitive functioning that have been diminished by disease or trauma. The main objective outcome for rehabilitation is to assist in regaining physical abilities and improving performance. Three common neuropsychological problems treatable with rehabilitation are attention deficit/hyperactivity disorder (ADHD), concussion, and spinal cord injury. Rehabilitation research and practices are a fertile area for clinical neuropsychologists, rehabilitation psychologists, and others.
Planning is the process of thinking regarding the activities required to achieve a desired goal. Planning is based on foresight, the fundamental capacity for mental time travel. Some researchers regard the evolution of forethought - the capacity to think ahead - as a prime mover in human evolution. Planning is a fundamental property of intelligent behavior. It involves the use of logic and imagination to visualize not only a desired result, but the steps necessary to achieve that result.
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.
Cognitive neuropsychology is a branch of cognitive psychology that aims to understand how the structure and function of the brain relates to specific psychological processes. Cognitive psychology is the science that looks at how mental processes are responsible for the cognitive abilities to store and produce new memories, produce language, recognize people and objects, as well as our ability to reason and problem solve. Cognitive neuropsychology places a particular emphasis on studying the cognitive effects of brain injury or neurological illness with a view to inferring models of normal cognitive functioning. Evidence is based on case studies of individual brain damaged patients who show deficits in brain areas and from patients who exhibit double dissociations. Double dissociations involve two patients and two tasks. One patient is impaired at one task but normal on the other, while the other patient is normal on the first task and impaired on the other. For example, patient A would be poor at reading printed words while still being normal at understanding spoken words, while the patient B would be normal at understanding written words and be poor at understanding spoken words. Scientists can interpret this information to explain how there is a single cognitive module for word comprehension. From studies like these, researchers infer that different areas of the brain are highly specialised. Cognitive neuropsychology can be distinguished from cognitive neuroscience, which is also interested in brain-damaged patients, but is particularly focused on uncovering the neural mechanisms underlying cognitive processes.
Clinical neuropsychology is a sub-field of cognitive science and 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 called pediatric neuropsychology.
Timothy Shallice is a professor of neuropsychology and the founding director of the Institute of Cognitive Neuroscience, part of University College London. He has been a professor at Cognitive Neuroscience Sector of the International School for Advanced Studies (SISSA) in Trieste, Italy since 1994 but is now retired.
The attempts to derive the links between the damage to specific brain areas and problems in behaviour are known throughout the history for 3 millennia. However, the first systematic neuropsychological assessment and a battery of the behavioural tasks to investigate specific aspects of behavioural regulation was developed by Alexander Luria in 1942-1948. Luria was working with big samples of brain-injured Russian soldiers during and after the second World War. Among many insights from Luria's rehabilitation practice and observations, was the fundamental discovery of the involvement of frontal lobes of the cortex in plasticity, initiation, planning and organization of behaviour. His Go/no-go task, which was one of the tasks screening for the frontal lobe damage, "count by 7", hands-clutching, clock-drawing task, drawing of repeatitive patterns, word associations and categories recall and others became standard components of neuropsychological assessment and mental status screening. Considering the originality and multiplicity of neuropsychological components offered by Alexander Luria, he is recognized as a father of neuropsychological assessment. Alexander Luria's neuropsychological battery was adapted in the United States in the form of Luria-Nebraska neuropsychological battery in 1970s. Then the tasks used in this battery were borrowed in more modern neuropsychological batteries and in the Mini–mental state examination test for screening of demenia.
The Wisconsin Card Sorting Test (WCST) is a neuropsychological test of set-shifting, which is the capability to show flexibility when exposed to changes in reinforcement. The WCST was written by David A. Grant and Esta A. Berg. The Professional Manual for the WCST was written by Robert K. Heaton, Gordon J. Chelune, Jack L. Talley, Gary G. Kay, and Glenn Curtiss.
In cognitive science and neuropsychology, executive functions are a set of cognitive processes that support goal-directed behavior, by regulating thoughts and actions through cognitive control, selecting and successfully monitoring actions that facilitate the attainment of chosen objectives. Executive functions include basic cognitive processes such as attentional control, cognitive inhibition, inhibitory control, working memory, and cognitive flexibility. Higher-order executive functions require the simultaneous use of multiple basic executive functions and include planning and fluid intelligence.
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."
NEPSY is a series of neuropsychological tests authored by Marit Korkman, Ursula Kirk and Sally Kemp, that is used in various combinations to assess neuropsychological development in children ages 3–16 years in six functional domains.
The Hayling and Brixton tests are neuropsychological tests of executive function created by psychologists Paul W. Burgess and Tim Shallice. It is composed of two tests, the Hayling Sentence Completion Test and the Brixton Spatial Awareness Test.
The Rey–Osterrieth complex figure (ROCF) is a neuropsychological assessment in which examinees are asked to reproduce a complicated line drawing, first by copying it freehand (recognition), and then drawing from memory (recall). Many different cognitive abilities are needed for a correct performance, and the test therefore permits the evaluation of different functions, such as visuospatial abilities, memory, attention, planning, working memory and. First proposed by Swiss psychologist André Rey in 1941 and further standardized by Paul-Alexandre Osterrieth in 1944, it is frequently used to further explain any secondary effect of brain injury in neurological patients, to test for the presence of dementia, or to study the degree of cognitive development in children.
The Trail Making Test is a neuropsychological test of visual attention and task switching. It has two parts, in which the subject is instructed to connect a set of 25 dots as quickly as possible while maintaining accuracy. The test can provide information about visual search speed, scanning, speed of processing, mental flexibility, and executive functioning. It is sensitive to cognitive impairment associated with dementia, including Alzheimer's disease.
Cognitive planning is one of the executive functions. It encompasses the neurological processes involved in the formulation, evaluation and selection of a sequence of thoughts and actions to achieve a desired goal. Various studies utilizing a combination of neuropsychological, neuropharmacological and functional neuroimaging approaches have suggested there is a positive relationship between impaired planning ability and damage to the frontal lobe.
The Luria–Nebraska Neuropsychological Battery (LNNB) is a standardized test that identifies neuropsychological deficiencies by measuring functioning on fourteen scales. It evaluates learning, experience, and cognitive skills. The test was created by Charles Golden in 1981 and based on previous work by Alexander Luria that emphasizes a qualitative instead of quantitative approach. The original, adult version is for use with ages fifteen and over, while the Luria–Nebraska Neuropsychological Battery for Children (LNNB-C) can be used with ages eight to twelve; both tests take two to three hours to administer. The LNNB has 269 items divided among fourteen scales, which are motor, rhythm, tactile, visual, receptive speech, expressive speech, writing, reading, arithmetic, memory, intellectual processes, pathognomonic, left hemisphere, and right hemisphere. The test is graded on scales that are correlated to regions of the brain to help identify which region may be damaged. The Luria–Nebraska has been found to be reliable and valid; it is comparable in this sense to other neuropsychological tests in its ability to differentiate between brain damage and mental illness. The test is used to diagnose and determine the nature of cognitive impairment, including the location of the brain damage, to understand the patient's brain structure and abilities, to pinpoint causes of behavior, and to help plan treatment.
Executive functions are a cognitive apparatus that controls and manages cognitive processes. Norman and Shallice (1980) proposed a model on executive functioning of attentional control that specifies how thought and action schemata become activated or suppressed for routine and non-routine circumstances. Schemas, or scripts, specify an individual's series of actions or thoughts under the influence of environmental conditions. Every stimulus condition turns on the activation of a response or schema. The initiation of appropriate schema under routine, well-learned situations is monitored by contention scheduling which laterally inhibits competing schemas for the control of cognitive apparatus. Under unique, non-routine procedures controls schema activation. The SAS is an executive monitoring system that oversees and controls contention scheduling by influencing schema activation probabilities and allowing for general strategies to be applied to novel problems or situations during automatic attentional processes.
The Division of Clinical Neuropsychology of the American Psychological Association is a scientific and professional organization of psychologists interested in neuropsychology and clinical neuropsychology, the study of brain-behavior relationships with a focus on applying this knowledge to human problems. The Division of Clinical Neuropsychology was established as a specialty organization within APA in 1980 and was formally recognized by APA in 1996 via the Committee for the Recognition of Specialties and Proficiencies in Professional Psychology". It has become one of APA's largest and most active divisions with over 4200 members worldwide. The Division of Clinical Neuropsychology has been instrumental in the development of clinical neuropsychology as a psychological specialty. This organization helped to establish policies and standards for practice and training in clinical neuropsychology as well as developed the definition of a clinical neuropsychologist, which has been used as a foundation by other neuropsychological organizations.
The Delis–Kaplan Executive Function System (D-KEFS) is a neuropsychological test used to measure a variety of verbal and nonverbal executive functions for both children and adults. This assessment was developed over the span of a decade by Dean Delis, Edith Kaplan, and Joel Kramer, and it was published in 2001. The D-KEFS comprises nine tests that were designed to stand alone. Therefore, there are no aggregate measures or composite scores for an examinee's performance. A vast majority of these tests are modified, pre-existing measures ; however, some of these measures are new indices of executive functions.
The Cogstate Brief Battery (CBB) is a computer-based cognitive assessment used in clinical trials, healthcare, and academic research to measure neurological cognition. It was developed by Cogstate Ltd.