Individual Subtests Research Articles

Особенности интеллектуального развития при расстройстве аутистического спектра (РАС)

<p style="text-align: justify;">The article presents an overview of the current understanding of the intellectual development of children and adults with autism spectrum disorder (ASD). A review of research indicates a wide heterogeneity in the levels of intellectual development in autism (from severe intellectual disability to giftedness) and demonstrates a lack of specific cognitive and intellectual profiles. The assessment of "strengths" and "weaknesses" of individual cognitive abilities and/or subtests of the measures comes to the fore. At the same time, the incidence of ASD and intellectual disability is higher than in the general population (33% to 70% in the studies reported in this article), indicating that these conditions are comorbid. These rates vary according to the methodological design of the studies, especially the type of data used (administrative, medical, educational, etc.) and the instruments used to assess intellectual ability. For example, Wechsler tests may underestimate scores in children and adults with ASD because of the large number of verbal instructions that are difficult for people with severe communication difficulties. Comprehensive nonverbal intelligence tests (e.g., Leiter-3 or UNIT-2) are the most appropriate methods. Assessing the level of intellectual ability in people with autism spectrum disorders in Russia is complicated by the existing deficit of methods, the elimination of which is an important task that researchers face.</p>

Testing the Continuum/Spectrum Model in Russian-Speaking Children With and Without Developmental Language Disorder.

Previously, Lancaster and Camarata (2019) showed that the continuum/spectrum model of the developmental language disorder (DLD) best explained the high heterogeneity of symptoms in children with DLD. We hypothesize that the continuum/spectrum approach can include not only children with DLD but also typically developing (TD) children with different timelines and patterns of language acquisition. This model can explain individual language profiles and deficits in children. We assessed language abilities in a group of Russian-speaking children with DLD aged 4-7 years (n = 53) and their age- and gender-matched peers without speech and language diagnoses (n = 53, TD). We evaluated the children's performance at four language levels in production and comprehension domains, using 11 subtests of the standardized language assessment for Russian: Russian Child Language Assessment Battery (RuCLAB). Using the k-means cluster method and RuCLAB scores, we obtained two clusters of children and analyzed their language performance in individual subtests. The analysis revealed that the two clusters of children both included DLD and TD participants: Group 1, with higher test scores (TD = 45, DLD = 24 children), and Group 2, with lower scores (TD = 8, DLD = 29). Children from Group 1 mostly had lower scores at one of the language levels, whereas those from Group 2 struggled at several language levels. Furthermore, children with DLD from both groups tended to be more sensitive to linguistic features such as word length, noun case, and sentence reversibility compared to TD children. The presence of two mixed groups shows that children with diagnosed DLD could perform on par with TD children, whereas some younger TD children could perform similarly to children with DLD. Our findings support the continuum/spectrum model: Linguistic skills in preschool children are a continuum, varying from high to poor skills at all language levels in comprehension and production. To describe a child's language profile, the tasks assessing all language levels should be used. https://doi.org/10.23641/asha.25521400.

Measuring Developmental Delays: Comparison of Parent Report and Direct Testing.

Developmental assessment is part of a comprehensive autism evaluation. During in-person evaluations, developmental assessment is completed via direct testing by an examiner. In telehealth evaluations, developmental assessment relies on caregiver-report instruments. This study examined correspondence between caregiver report and direct testing of developmental skills. Participants were 93 children, aged 18-42 months, undergoing evaluation for possible autism spectrum disorder (ASD). Caregivers were interviewed with the Developmental Profile, 4th edition (DP-4) via telehealth platform and children were tested in person 2-4 weeks later using the Mullen Scales of Early Learning (MSEL). Correlations between the DP-4 and MSEL were high (ranging from 0.50 to 0.82) across standard scores, age equivalents, and functional categories, as well as across individual subtests and overall composite scores. The high convergent validity found in this study suggests that the DP-4 provides a suitable proxy for direct developmental testing using the MSEL in the context of telehealth evaluations for ASD in young children, delivering a good estimate of both developmental functioning and presence of delays. Data were obtained from registered clinical trial NCT05047224, date of registration 2021-09-07.

Non-psychologist practitioners' views of cognitive assessment reports: An evaluation of a learning disability child and adolescent mental health service.

This report details a service evaluation for a learning disability child and adolescent mental health service. The project aimed to explore nonpsychologist healthcare professionals' views of the accessibility and utility of cognitive assessment reports produced in the service. Semistructured interviews were conducted with eight healthcare professionals. Thematic analysis identified three themes: value of reports, readability, and acknowledging multiple audiences, each with supplementary subthemes. The following were recommended: shorter reports; simpler language; examples and recommendations pertinent and applicable to individual clients (supported by the case holder if the assessor is unfamiliar with the client); visual information to support written text; assessor to provide verbal feedback in addition to the written report; main report should contain information most pertinent to families and professionals: the clients' level of functioning/abilities and recommended interventions, whilst the appendix should contain supplementary information such as scoring and performance on individual subtests.

A Single-Stage Population-Based Study of the Relationship between Cognitive and Somatic Health Parameters in Children of Secondary School Age

Background. One of the four important components of the formation of cognitive functions is somatic health. But to date, there are no population studies that consider the relationship with cognitive functions and school performance of a large range of somatic factors, which allows us to compare the strength of their hypothetical contribution to cognitive functioning with each other. This study is the second part of a population-based study, the first part of which is presented in the previous publication "A Single-Stage Population-Based Study of the Prevalence of Mild Cognitive Impairment in Children of Secondary School Age". Aims — to determine the main patterns in the relationship between cognitive-academic and somatic factors in a cohort of Russian children, 5th grade students at school. Methods. In Russian schoolchildren of the 5th grades of municipalities representing cities of all federal districts of the Russian Federation, the links with integrative cognitive success, the number of subtests performed at the level of mild cognitive impairment, the results of individual cognitive subtests, academic performance and the leading hand factor were analyzed — the following somatic factors: the presence of skin pathology, bronchial asthma, orthopedic, ophthalmological disorders, visual acuity, body mass index, parameters of the study of the function of external respiration, electrocardiography, ultrasound examination of the thyroid gland, laboratory blood tests. Results. The results of the survey of 1036 participants, 51% of them girls, were admitted to the analysis. It has been established that iron content is directly related to integrative cognitive success and school performance, the relationship is especially strong between subgroups of iron content above and below 26.4 mmol/l. Clinical levels of erythrocytes are more strongly associated with integrative cognitive success and individual cognitive functions than other factors: in erythropenia cognitive parameters are worse. The presence of thyroid cysts directly correlates with some of the worst parameters of cognitive activity. High body mass index and low hemoglobin are associated with poorer academic performance. Conclusions. The results of the study for the first time on a cohort of Russian schoolchildren showed a connection with cognitive activity and school performance of a number of somatic factors, including iron content, which requires further in-depth study.

Evaluation of reliability and validity of the Serbian Aphasia Screening Test.

A rise in strokes worldwide means that the number of people affected by aphasia is increasing. Early and accurate diagnosis of aphasia is crucial for recovery. Presently, there are no dedicated screening tests tailored for evaluating aphasia in Serbian-speaking individuals. This paper presents and describes the psychometric properties of the Serbian Aphasia Screening Test (SAST), a novel aphasia screening tool designed specifically for Serbian speakers. This initiative fills the gap in aphasia assessment tools for the Serbian population, providing a comprehensive and culturally sensitive approach to the evaluation of language disorders. Data using the SAST were collected from 240 participants: 120 Serbian speakers with aphasia after stroke compared to 120 neurotypical individuals. The assessment included the following subtests: conversation, verbal automatized sequences, auditory comprehension, visual confrontation naming, responsive naming, repetition of words, repetition of sentences, oral word reading, oral sentence reading, reading comprehension, and writing. The main objectives were to ascertain the psychometric qualities of the SAST, including inter-rater reliability of scoring, test-retest reliability, reliability of the individual subtests, overall test reliability, and inter-correlations among subtests. Additionally, the study evaluated the discriminatory capability of the SAST in distinguishing between individuals with aphasia and neurotypical controls, as well as between individuals with different types of aphasia. The findings revealed that the SAST has excellent inter-rater reliability, test-retest reliability, and internal consistency. There were statistically significant differences between individuals with aphasia and neurotypical controls on all SAST subtests. Furthermore, the study identified significant differences in language profiles among participants with different types of aphasia. The significant correlations between scores on the SAST and on the Boston Diagnostic Aphasia Examination (BDAE) suggest good convergent validity of the SAST. The results underscore the robust psychometric properties of this novel screening assessment (SAST) and its ability to effectively discriminate between diverse linguistic abilities within different aphasia syndromes in Serbian speaking individuals.

A comparison of WPPSI-IV performance between Finland-Swedish minority children and the Scandinavian test norms: Findings from The FinSwed Study.

The Swedish Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV) is commonly used for assessing young children belonging to the Swedish-speaking minority in Finland (Finland-Swedes), but there is no information about the generalizability of this test and its norms to this minority. Cross-cultural comparisons of WPPSI-IV are also scarce. We compared the performance of Finland-Swedish children to the Scandinavian norms of the Swedish WPPSI-IV and explored the relationship between sociodemographic factors (age, sex, parental education level, bilingualism) and the performance. The Swedish WPPSI-IV was administered to 79 typically developing 5-6-year-old Finland-Swedish children assessed for The FinSwed Study. Their performance was compared to the Scandinavian norms using MANOVA, t-test, and confidence interval comparisons. Associations with sociodemographic variables were explored using regression analyses. Finland-Swedish children performed, on average, 1/3 SD higher than the Scandinavian norms, a difference which was statistically significant with medium-sized effects. However, individual subtests and indexes did not differ significantly from the norms. Significant associations with sociodemographic factors were found for some but not all index scores. This study provides clinically important information for using the Swedish WPPSI-IV with the Finland-Swedish minority and demonstrates aspects that clinicians working with this minority should take into account. The results are presumably partly explained by characteristics of the present sample, and partly by cultural and linguistic differences between the Finland-Swedish population and the Scandinavian countries. The findings also illustrate that cross-cultural differences in cognitive performance may be present even between similar cultures with the same language.

Neuropsychological Aspects of Children's Somatic Disorders in Chronic Diseases: Diabetes and Short Stature in the Developmental Period.

The study was carried out on 88 children with type 1 diabetes, 38 children suffering from short stature caused by (GHD), as well as a control group comprising 40 healthy children. Weschler's tests were applied to measure intellectual and cognitive functions. The results suggest that for children suffering from type 1 diabetes and short stature, their chronic childhood diseases per se do not impair cognitive development. It was observed that the higher the age of chronically ill children and the longer the disease persists, the lower their scores in individual cognitive subtests. For healthy children, age is correlated with the acquisition of particular skills and higher scores in specific subtests. On the basis of qualitative analysis of the cognitive functions subject to the study and close clinical observation of chronically ill children, we have been able to conclude that chronic diseases may alter cognitive functioning.

A single-stage population-based study of the prevalence of mild cognitive impairment in children of secondary school age.

Background: Various mild cognitive impairments in children are socially significant disorders that are often found in the practice of pediatric neurologists, but the apparent lack of epidemiological data does not allow us to judge the scale of the problem. 
 Aims: The aim of the study was to assess the prevalence of combined mild cognitive disorders in a large cohort of Russian children, 5th grade students at school.
 Materials and methods: The results of the examination of Russian schoolchildren of municipalities representing cities of all federal districts of the Russian Federation (RF) are analyzed. Cognitive functions were tested, which consisted of six subtests. According to the results of testing, using the method of assessing cognitive functions in population studies, the frequency of assigning participants to a high-risk group of combined mild cognitive impairment and the probability of diagnosis of combined mild cognitive impairment were evaluated. The analysis of the links between the breadth of results performed at the level of mild cognitive impairment, integrative cognitive success, the results of individual cognitive subtests with academic performance and the leading hand factor was carried out. .
 Results: 1,067 5th grade students at school were included in the study, 1,036 participants completed it, 51% of them girls. Belonging to the cluster of integrative cognitive successes and representation of the leading hand had no gender differences, subtests for visual-spatial perception/memory and constructive practice were better performed by boys (p 0.001 and p = 0.020), and girls, as a rule, performed better subtests for verbal-logical thinking and voluntary activity. attention (p = 0.050 and p = 0.051). According to the results of cognitive testing, a high risk of combined mild cognitive impairment was detected in 30.2% of the examined, and the probability of diagnosis of combined mild cognitive impairment was 7.5%. It was found that of the studied factors, the breadth of the results obtained at the level of moderate cognitive impairment and the effectiveness of the verbal-logical thinking subtest are more related to academic performance. At the same time, the strength of these ties was very moderate. The image of the leading hand was in no way associated with cognitive factors, including academic performance at the level of moderate cognitive impairment, but left-handedness was partially associated with better academic performance in literature.
 Conclusions: The results of the study, conducted for the first time on a multi-regional cohort of Russian schoolchildren, demonstrated a wide scale of the potential prevalence of mild cognitive impairment in children, and also revealed a number of patterns in the neurobiology of cognitive development.

13 The Relationship Between Body Mass Index (BMI) and Cognitive Performance Among Overweight Adults

Objective:While previous research has repeatedly indicated that greater BMI was associated with reduced cognitive performance, emerging literature on BMI and cognition in late life (age 65 and above) shows conflicting results. Recent studies (Luchsinger et al., 2013; Arvanitakis, Capuano, Bennett, & Barnes, 2018) have found that high BMI was associated with improved processing speed and verbal memory performance in older adults, but further research is needed to examine this relationship across additional aspects of cognition. The current study aims to build upon recent literature by exploring the relationship between BMI and four cognitive domains across the adult age span.Participants and Methods:Adults between the ages of 25-84 (n=217) were recruited for the Loma Linda University Healthy Avocado Trial study. Participants had a mean age of 49.61 (SD=13.13), mean education of 14.66 years (SD=2.44), and a mean BMI of 33.87 (SD=5.48). Cognition was measured using a two-hour neurocognitive battery divided into four discrete domains: attention/working memory (Digit Span, Auditory Consonant Trigrams), processing speed (Trail Making Test Part A, Stroop Color, Stroop Word, Symbol Digit Modalities Test), executive function (FAS/Phonemic Fluency, Stroop Word-Color, Trail Making Test Part B), and learning/memory (Rey Auditory Verbal Learning Test [RAVLT], Brief Visuospatial Memory Test-Revised [BVMT-R]). Individual test scores were standardized around the sample means and standard deviations, and cognitive domain scores were calculated as an average of the relevant standardized scores; a global cognition score represents the average of tests across all four domains. Participants were divided into three age groups (25-40, 41-60, and 61-84). Correlational analyses were performed between BMI and cognitive domain scores within each age group, while controlling for age, sex, and education.Results:No significant correlations were observed between BMI and any of the cognitive domains among adults aged 25-40 and 41-60. Among adults aged 61-84, a significant association was found between BMI and learning and memory (r=0.390, p=0.011). An examination of individual subtests within the domain revealed significant positive correlations between BMI and RAVLT short delay recall (r=0.338, p=0.029) and long delay recall (r=0.353, p=0.022), and between BMI and BVMT-R immediate- (r=0.351, p=0.023) and delayed recall (r=0.332, p=0.032). A trend for the association between BMI on global cognition was also observed in the oldest age group (r=0.275, p=0.078). No significant associations were observed between BMI and the domains of attention/working memory, processing speed, or executive function.Conclusions:No significant associations were observed between BMI and cognitive performance among young- and middle-aged adults. However, among older adults aged 6184, higher BMI was associated with higher scores on both verbal and nonverbal learning & memory. These findings support the 'obesity paradox,' suggesting that increased BMI may be protective for elderly adults. Multiple explanations for this relationship have been proposed, including the role of BMI in the body’s inflammatory response system, as well as observations of dementia-related weight loss. Further research is needed to determine whether BMI has a protective benefit, or if it is simply a clinical marker of underlying disease.

All Scores Are Not Equal: Evaluating Score Reliability to Improve the Interpretation of Results From Tests of Intelligence in Clinical, Forensic, and School Settings

Tests of intelligence are administered in clinical, forensic, and school settings. The score most practitioners are familiar with is the Full-Scale Intelligence Quotient (FSIQ). An individual’s FSIQ score is often used for program eligibility and is the most reliable score. In addition to the FSIQ, practitioners often evaluate an examinee’s performance on factor/composite scores. These scores may be used to evaluate an individual’s personal strengths and weaknesses but are less reliable than the FSIQ score. The least reliable scores on an intelligence test are the test’s scaled scores, which are derived from raw scores on individual subtests. It is important for clinicians and practitioners to be aware of the interpretation of scaled scores, but also of their relativly low reliability and higher variability when compared to the FSIQ and factor/composite scores. Because of their lower reliability and variability, clinicians are urged to use extreme caution when interpretating an examinee’s performance on an intelligence test at the scaled score level.

Sensitivity and specificity of the ECAS in identifying executive function and social cognition deficits in MND

Objective: Motor neurone disease [MND] encompasses broad cognitive impairments, which are not fully captured by most screening tools. This study evaluated the specificity and sensitivity of the Edinburgh Cognitive and Behavioral ALS Screen [ECAS] in detecting impairments in executive function and social cognition. Methods: Participants (MND = 64; Healthy Controls = 45) completed the ECAS and standard neuropsychology tests of executive function and social cognition. Sensitivity and specificity of the ECAS were assessed at three levels (ALS-Specific score, executive function domain score, individual subtests: social cognition, inhibition, working memory, alternation). Results: MND patients were impaired on standard social cognition, initiation, visuomotor alternation, and verbal learning tests but not on inhibition or working memory tests, relative to controls. ECAS results revealed that the ALS-Specific score was high in specificity but low-to-moderately sensitive in identifying social cognition, inhibition, and working memory deficits, and that both sensitivity and specificity were high for identifying alternation deficits. The ECAS executive function domain score was high in specificity but poor in sensitivity for all four executive function domain subtests. The individual ECAS subtests were highly specific with good sensitivity, but the social cognition subtest lacked sensitivity. Conclusions: Impairments in social cognition may go undetected when using the ECAS as a screening tool. Thus, social cognition may need to be considered as a standalone component, distinct from the other executive functions. In addition, the test itself may need to be adjusted to encompass other aspects of social cognition that are affected in MND. Key messages Cognitive screening tools are key to detect cognitive changes in MND, with the domains most affected being executive functions, language, and social cognition. The ECAS measure, developed for MND, has good specificity but lacks sensitivity to impairments in social cognition. Clinical implications are that cognitive impairments in social cognition may not be identified in MND patients by the ECAS. Adjustment to the ECAS cognitive screening tool widely-used in MND is suggested.

The Relationship Between Social Intelligence And IQ: A Psychometric Analysis

Background: The present article deals with the results of research on the psychological diagnosis of social intelligence and its connection with general intelligence. Methods: The analysis of the relationship between the Social Intelligence Scale of the University of Tromso, Norway (TSIS) (Social awareness scale, SA) with the R. Amthauer Intelligence Test was carried out on a sample of 407 students of comprehensive schools aged from 12 to 18. Social Intelligence Scales have relationships with R. Amthauer Intelligence Test. Factor analysis has shown that the TSIS (Social Awareness, SA) is present in the structure of general intelligence. The other two TSIS Social information processing (SP) and Social Skills (SS) scales have minor correlation relationships with R. Amthauer Intelligence Test. The result shows the structural relationships between general intelligence with social intelligence. The aim of the research is to identify and analyze the regular relationship between general intelligence (IQ) with social intelligence. Results: The correlational and factor analysis results established certain relationships in the factor-analytical structure of general intelligence with social intelligence. The correlation relationship of the social awareness subscale (SA) from the Social Intelligence Scale (TSIS) with individual subtests of the R. Amthauer Intelligence Structure Test was revealed. Conclusion: Our study established a statistically significant relationship at the significance level of 0.05 between IQ and social intelligence, particularly social consciousness (understanding), which allowed us to connect social intelligence and general (psychometric) intelligence.

The Seoul Neuropsychological Screening Battery (SNSB) for Comprehensive Neuropsychological Assessment.

The Seoul Neuropsychological Screening Battery (SNSB) is known as a representative comprehensive neuropsychological evaluation tool in Korea since its first standardization in 2003. It was the main neuropsychological evaluation tool in the Clinical Research Center for Dementia of South Korea, a large-scale multi-center cohort study in Korea that was started in 2005. Since then, it has been widely used by dementia clinicians, and further solidified its status as a representative dementia evaluation tool in Korea. Many research results related to the SNSB have been used as a basis for the diagnosis and evaluation of patients in various clinical settings, especially, in many areas of cognitive assessment, including dementia evaluation. The SNSB version that was updated in 2012 provides psychometrically improved norms and indicators through a model-based standardization procedure based on a theoretical probability distribution in the norm's development. By providing a score for each cognitive domain, it is easier to compare cognitive abilities between domains and to identify changes in cognitive domain functions over time. Through the development of the SNSB-Core, a short form composed of core tests, which also give a composite score was provided. The SNSB is a useful test battery that provides key information on the evaluation of early cognitive decline, analysis of cognitive decline patterns, judging the severity of dementia, and differential diagnosis of dementia. This review will provide a broad understanding of the SNSB by describing the test composition, contents of individual subtests, characteristics of standardization, analysis of the changed standard score, and related studies.

Reproductive health data and its relationship to baseline brain imaging and cognitive measurements in cognitively unimpaired female PSEN1 E280A mutation carriers and non‐carriers from the API ADAD Trial

AbstractBackgroundThe impact of sex steroid hormones on Alzheimer’s disease (AD) remains to be further clarified. Research suggests that shorter reproductive span, late menarcheal age, early menopause, oophorectomies and hysterectomies, are associated with increased dementia risk. We examined reproductive health and its associations with brain imaging and cognitive measurements in unimpaired female Presenilin 1 (PSEN1) E280A mutation carriers and non‐carriers from the Alzheimer’s Prevention Initiative Autosomal Dominant AD (API ADAD) Trial (NCT01998841).MethodA total of 151 cognitively unimpaired 30‐53 year‐old females (101 PSEN1 mutation carriers and 50 non‐carriers) were included. Reproductive health data (i.e., menarcheal age, number of pregnancies, deliveries, miscarriages, and living children) from all participants were examined, as well as the extent to which menarcheal age was related to age‐adjusted baseline 1) cortical amyloid plaque burden (florbetapir PET), 2) Precuneus cerebral glucose metabolism (fluorodeoxyglucose PET), 3) hippocampal volume (3TMRI), and 4) the API ADAD preclinical cognitive composite score, which includes the MMSE Orientation score, CERAD Word List Delayed Recall and Constructional Praxis, Multilingual Naming Test and Raven’s Progressive Matrices subset. We examined associations with the cognitive and brain imaging measures corrected for multiple comparisons (Bonferroni).ResultCarrier and non‐carrier females did not differ on number of pregnancies, deliveries, miscarriages, or living children. Female carriers had a significantly younger menarcheal age than non‐carriers (12.8 ±1.5 versus 13.7±1.6 years, p = 0.007, Bonferroni). Among carrier females, older menarcheal age was associated with lower scores on the Raven’s test (Bonferroni: r = ‒0.28,p =0.035). Menarcheal age was not associated with scores on the cognitive composite or other individual subtests, or with brain imaging measures.ConclusionOur findings suggest reproductive health data did not differ between carrier and non‐carrier females, except for a slightly younger menarcheal age compared to non‐carriers, and that menarcheal age may have a very limited impact on brain pathology and function at preclinical stages of ADAD. Longitudinal studies with larger samples are needed to clarify the extent to which earlier menarcheal age may be related to changes in cognitive function in mutation carrier females transitioning from preclinical to clinical stages.

Short term memory in aphasia: effects of modality and relationship with Western Aphasia Battery-R performance

ABSTRACT Background Producing and comprehending language requires maintenance of linguistic units in short term memory (STM). While there is evidence of verbal STM impairments in persons with aphasia (PWA), there are unresolved questions about other aspects of STM in aphasia, particularly the role of input and output modalities on STM performance. This includes the extent to which visual STM abilities are impaired in PWA and if the modality of eliciting responses (verbal versus pointing) influences STM performance. A better understanding of the relationship between STM performance and clinical language assessments of PWA will inform test interpretation. Aims This study investigated three questions about short term memory (STM) performance in post-stroke aphasia: 1) whether visual STM is impaired in PWA given that a common neural network subserves encoding-recall of both verbal and visual STM, 2) whether the response modality (verbal vs pointing) impacts STM score, 3) the relationship between STM and language performance, specifically on the Western Aphasia Battery-Revised (WAB-R). Methods & Procedures Verbal and visuo-spatial performance on a STM battery was compared between 45 PWA and a representative neurotypical sample (N=40). For PWA, individual performance across STM subtasks was examined to identify dissociations and correlated with language performance on the WAB-R. Outcomes & Results PWA scored lower than neurotypical controls on verbal but not visual STM tasks. At the individual level, about one-half of PWA were impaired on the three verbal STM tasks, and one-third had dissociations among the three verbal STM tasks. There was no effect of response modality (verbal versus pointing) on verbal STM performance. There was a strong association between verbal STM and individual subtests of the WAB-R. In general, the relative phonological and semantic demands of the task (e.g. repetition) influenced the association strength with digit recall versus picture recall scores. Conclusions Verbal STM deficits are: 1) more prevalent than visual-spatial STM deficits in PWA, 2) strongly associated with WAB-R performance in a pattern that is consistent with the phonological and semantic demands of the tasks. The clinical implications of this study are that it is crucial to assess STM performance in PWA and examine its potential impact on language assessments. Further, a verbal or pointing response modality can be used for STM measurement without negatively impacting the score (unless there are clear motoric contra-indications). This study provides performance data for a set of aphasia-friendly STM tasks that can serve as future reference.

Multivariate models provide an effective psychometric solution to the variability in classification accuracy of D-KEFS Stroop performance validity cutoffs

ObjectiveThe study was designed to expand on the results of previous investigations on the D-KEFS Stroop as a performance validity test (PVT), which produced diverging conclusions. Method The classification accuracy of previously proposed validity cutoffs on the D-KEFS Stroop was computed against four different criterion PVTs in two independent samples: patients with uncomplicated mild TBI (n = 68) and disability benefit applicants (n = 49). Results Age-corrected scaled scores (ACSSs) ≤6 on individual subtests often fell short of specificity standards. Making the cutoffs more conservative improved specificity, but at a significant cost to sensitivity. In contrast, multivariate models (≥3 failures at ACSS ≤6 or ≥2 failures at ACSS ≤5 on the four subtests) produced good combinations of sensitivity (.39-.79) and specificity (.85-1.00), correctly classifying 74.6-90.6% of the sample. A novel validity scale, the D-KEFS Stroop Index correctly classified between 78.7% and 93.3% of the sample. Conclusions A multivariate approach to performance validity assessment provides a methodological safeguard against sample- and instrument-specific fluctuations in classification accuracy, strikes a reasonable balance between sensitivity and specificity, and mitigates the invalid before impaired paradox.

Construct validity of the NIH toolbox cognitive domains: A comparison with conventional neuropsychological assessments.

Previous studies have assessed the construct validity of individual subtests in the National Institutes of Health (NIH) Toolbox Cognition Battery (NIHTB-CB), though none have examined the construct validity of the cognitive domains. Importantly, the original NIHTB-CB validation studies were administered on a desktop computer, though the NIHTB-CB is now solely administered via an iPad. We examined the construct validity of each cognitive domain assessed in the NIHTB-CB, including a motor dexterity domain using the iPad application compared to a neuropsychological battery in a sample of healthy adults. Eighty-three adults aged 20-66 years (M = 44.35 ± 13.41 years) completed the NIHTB-CB and a comprehensive neuropsychological assessment. Domain scores for each of six cognitive domains (attention and executive function, episodic memory, working memory, processing speed, language, and motor dexterity) and the fluid composite were computed for both batteries. We then assessed the construct validity using Pearson correlations and intraclass correlation coefficients (ICCs) for both demographically corrected and uncorrected domains. We found the attention and executive function, episodic memory, and processing speed domains had poor-to-adequate construct validity (ICCConsistency = -0.029 to 0.517), the working memory and motor dexterity domains and the fluid composite had poor-to-good construct validity (ICCConsistency = 0.215-0.801), and the language domain had adequate-to-good construct validity (ICCConsistency = 0.408-0.829). The NIHTB-CB cognitive domains have poor-to-good construct validity, thus researchers should be aware that some tests representing cognitive constructs may not fully reflect the cognitive domain of interest. Future investigation of the construct validity and reliability of the NIHTB-CB administered using the iPad is recommended. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Relationship between Aphasia Impairment and Communication Confidence in Mild Aphasia

ABSTRACT Purpose Aphasia is a post-stroke condition that can dramatically impact a person with aphasia’s (PWA) communication abilities. However, clinicians often focus on level of impairment as their primary outcome of interest. An emerging literature suggests that greater emphasis should be placed on the impact that aphasia has on communication confidence and how it is influenced by the level of aphasia impairment. Methods To examine the interrelationship between aphasia impairment and communication confidence in individuals with mild aphasia, data from 12 PWA related to impairment and communication confidence were collected at the time of enrollment in a telepractice rehabilitation program. Impairment was measured with the Western Aphasia Battery – Revised (WAB-R) aphasia quotient (AQ) as well as individual subtest scores and communication confidence was measured using the Communication Confidence Rating Scale for Aphasia (CCRSA). Bayesian descriptive statistics and regression estimation were used to examine the interrelationship between these instruments controlling for basic demographic heterogeneity. Results Bayesian discrete dependent variable analysis showed that CCRSA was positively correlated with age (β =0.015, sd=0.00012), education level (β=0.023, sd=0.00052), and WAB-R repetition (β=0.0276, sd=0.00321), but only slightly, negatively related to WAB-R AQ (β= -0.0013, sd=0.0002), WAB-R auditory comprehension (β= -0.223, sd=0.26926), and WAB-R naming (β= -0.5425, sd=0.38406). Conclusions Communication of confidence was only slightly correlated with aphasia impairment, but significantly and positively correlated with age and educational level in individuals mild with aphasia. These findings suggest that in individuals with the mildest form of aphasia, communication confidence is primarily driven by specific individual, nonclinical characteristics unique to the PWA and their communication demands rather than the absolute level of communication impairment.

Correspondence between MMSE and detailed neuropsychological testing in Parkinson’s disease

Although the Mini-Mental Status Examination (MMSE) has long been criticised as being insufficiently sensitive to cognitive decline, it is still considered fundamental for the diagnosis of cognitive impairment in Parkinson’s disease, with many papers continuing to use this tool to characterise cognition. This study investigates how intact performance on the MMSE in Parkinson’s disease relates to performance on detailed neuropsychological testing, and how intact performance on individual MMSE subtests corresponds to performance on cognate neuropsychological tests. We examined the wider neuropsychological performance of 264 PD patients screened using the MMSE. 85.7 per cent of PD patients passing the MMSE demonstrated impairment upon detailed neuropsychological assessment, more frequently on non-MMSE domains (76.1 per cent) than MMSE domains (40.8 per cent). Furthermore, despite performing flawlessly on individual MMSE domains, up to 22.6 per cent failed cognate tests upon detailed neuropsychological testing. We conclude that the MMSE is inadequate for the accurate detection or characterisation of cognitive impairment in PD.