B - 35 An Application of the ECLECTIC Framework to Neuropsychological Evaluation of a Korean-Speaking Older Adult with End-Stage Renal Disease (ESRD): a Case Study.

Abstract

The ECLECTIC framework (Fujii, 2018) provides a comprehensive and systematic approach to addressing ethnic diversity in neuropsychological assessment, moving beyond a focus only on test and normative group. It presents a unique opportunity to gain cultural insight, establish rapport and trust, integrate contextual factors, and tailor recommendations. We present a case that illustrates the application of this framework to the neuropsychological evaluation of a first-generation Korean American, bilingual man in his mid-60s. The patient emigrated to the United States from South Korea in his 30s. He was referred for neuropsychological evaluation for cognitive problems after ESRD diagnosis. Consistent with ECLECTIC framework, hypothesis-testing and qualitative analysis were conducted to create cultural and linguistic equivalence. Informant reports were collected and incorporated. Linguistic competency was established, and a Korean interpreter was used. The flexible battery included Korean- and English-translated measures. Cognitive performance was normed against peer groups with similar demographics (age, gender, academic level), and interpreted within cultural contextual factors (education quality, highest occupation, immigration context, linguistic competence, informant report). Results indicated significant memory impairment with relatively preserved language and visuospatial skills. He endorsed severe depression. Recognizing the impact of cultural biases on the assessment of Korean-speaking individuals with medical comorbidities, we found the ECLECTIC framework to be a valuable tool in supporting careful consideration of cultural and contextual factors in the absence of a cultural broker or Korean-speaking neuropsychologist. Overall, the ECLECTIC model offers an example for clinicians and trainees to employ a culturally responsive framework for ethnically diverse patients.