Применение скрининговых шкал в нейропсихологической реабилитации: возможности, требования и ограничения

Abstract

Popularity of screening scales in the assessment of cognitive functions in neuropsychological rehabilitation often involves their direct adoption in Russia without appropriate approbation and improper conclusions. In the article based on the examples of Montreal Cognitive Assessment and the Mini-Mental State Examination we consider the requirements, limitations and conditions for the use of standardized instruments in cognitive neuropsychology in Russia. We consider four groups of requirements: (1) taking into account the theoretical basis of the methodic, (2) keeping the scope, conditions and samples described for the instrument, (3) adaptation and validation in Russia, (4) the choice of psychometric indicators that take into inter-disciplinary demands and goals for rehabilitation. Since the process, the principles and the results of neuropsychological diagnostics, as well as setting goals and selection methods for rehabilitation depend on the neuropsychological approach that the specialist uses, comparison of neurocognitive approach with the system-dynamic approach to localization of higher mental functions is necessary. The results of neuropsychological testing, based on one theoretical approach can be understood, qualified and substantiated within the framework of a different approach, but not directly transferred. Screening tools have a limited task of identifying high-risk groups for subsequent more detailed examination and if dynamics of the large groups is assessed, but they cannot substitute neuropsychological examination. In accordance with the principles of neurocognitive approach on which screening tools are based, their use requires to proove not only linguistic, but also the construct, measurement and metric equivalence to the original version of the test. Choice of psychometric properties that are important to justify the applicability of the instrument for concrete rehabilitation tasks is ambiguous and depends on the objectives (diagnostics, rehabilitation, expertise, etc.), target groups and interdisciplinary requirements.