comparison of psych assessments

[Mattalbie]

Do you have a preference in the psych tests you administer? For example a WJ compared to a Weschler for measuring cog ability, why would you choose one over the other? Similarly with a neuropsych tests which have similar subtests. Is it ease of administration, scoring or just familiarity?

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[erg923]

Do you have a preference in the psych tests you administer? For example a WJ compared to a Weschler for measuring cog ability, why would you choose one over the other? Similarly with a neuropsych tests which have similar subtests. Is it ease of administration, scoring or just familiarity?

Yes, of course. Test selection depends on factors too numerous to describe here, but include referral question, age and ability level of the patient, availablility normative data for the test, etc. However, we all certainly have favorites and fall backs... and simple familiarity is big part of that of course. I would really not choose WJ over Wechsler in most circumstances because even though the WJ is very good, I would be hard pressed to explain to an opposing attorney why I picked the less psychometrically rigorous and researched test. I would just prefer to avoid that potential complication should the case get dragged to court for some reason.

I am rather astonstonied, not only on by the field's loyalty to David Wechsler's model, but also by the dominance of the Wechsler Memory Scales (WMS). Exactly how the WMS series has gained the monopoly that it has over the years is beyond me. Test like the WRAML, MAS, and the like have never had a chance to really get widespread use in adult pops because of WMS monopoly. I really think thats a shame sometimes.

 

[IT514]

Yes, of course. Test selection depends on factors too numerous to describe here, but include referral question, age and ability level of the patient, availablility normative data for the test, etc. However, we all certainly have favorites and fall backs... and simple familiarity is big part of that of course. I would really not choose WJ over Wechsler in most circumstances because even though the WJ is very good, I would be hard pressed to explain to an opposing attorney why I picked the less psychometrically rigorous and researched test. I would just prefer to avoid that potential complication should the case get dragged to court for some reason.

I'm totally in agreement with your advice, erg. But just as an example of the complexities of test selection for the OP, choosing a Wechsler over the WJ based on norms and research would be good practice in many cases, but definitely not if a kid below grade 6 is referred to you due to reading problems. Although the WIAT is a better measure of "real world" reading comprehension, it is confounded by working memory, which the WJ separates out and gives you a clearer picture of the kids ability to comprehend the text. In a rule out of dyslexia, knowing this stuff is important for drawing conclusions. In this case a WISC would be great for working memory and general intellect, but the WJ would be a better choice for the achievement aspect. And of course you could add whatever tests you want to complete the battery (GORT, DST, CTOPP etc, etc).

I think my belabored point is that knowledge of the referral question and knowing the pros and cons of each test is the best way to go in each case. Couple this with understanding the tests sensitivity to the neuroanatomy under consideration, and you'll have a pretty comprehensive rationale. A great resource is the Compendium of Neuropsychological Tests, which I refer to frequently.

 

[Therapist4Chnge]

A great resource is the Compendium of Neuropsychological Tests, which I refer to frequently.

And it is a great door stop!

I love my Compendium, and I have a few dozen marked Post-It notes to prove it.

 

[Mattalbie]

Thanks very helpful advice.

 

[AcronymAllergy]

And it is a great door stop!

I love my Compendium, and I have a few dozen marked Post-It notes to prove it.

The Compendium, Lezak's "Neuropsychological Assessment," Mitrushina's "Handbook of Normative Data for Neuropsychological Assessment," and Heilman and Valenstein's "Clinical Neuropsychology," should, in my opinion, be required materials for all neuropsych-oriented programs. They're all excellent resources for a variety of material.

 

[Neuropsych2be]

Yes, of course. Test selection depends on factors too numerous to describe here, but include referral question, age and ability level of the patient, availablility normative data for the test, etc. However, we all certainly have favorites and fall backs... and simple familiarity is big part of that of course. I would really not choose WJ over Wechsler in most circumstances because even though the WJ is very good, I would be hard pressed to explain to an opposing attorney why I picked the less psychometrically rigorous and researched test. I would just prefer to avoid that potential complication should the case get dragged to court for some reason.

I am rather astonstonied, not only on by the field's loyalty to David Wechsler's model, but also by the dominance of the Wechsler Memory Scales (WMS). Exactly how the WMS series has gained the monopoly that it has over the years is beyond me. Test like the WRAML, MAS, and the like have never had a chance to really get widespread use in adult pops because of WMS monopoly. I really think thats a shame sometimes.

The WMS and its various iterations have garnered quite a following. I was originally trained on the WMS-R so I am dating myself 🙂 I think the main reason it the utilization of the same normative sample as the WAIS thereby allowing one to relate memory scores to the Wechsler scales. However, the creators of the WMS have consistently failed to get those pesky factor analytic studies to show that the instrument measures what they say it measures. quality does not mean the same thing as popularity.

 

[Therapist4Chnge]

...quality does not mean the same thing as popularity.

*cough* Rorschach *cough* Ham-D in pharma research *cough* etc.

The WMS is unfortunately not very practical for clinicians who have limited time to complete an assessment. I use parts of the WMS, but I can't tell you the last time I gave it front to back....probably when I first learned it in graduate school. Even if I have a psych tech administer everything, it usually isn't worth the time.

 

[erg923]

I rarely have given the entire WMS. . . a few tests, yes, but not the whole thing.

Let's say I have an adult epilepsy case, relatively high functioning individual, I might do:

RBANS (includes a list learning task, logical memory, complex figure)
CVLT-2
BVMT-R
WMS
- corsi blocks (spatial span)
- digit span
- letter-number sequencing

Alzheimer's differential might get:

HVLT-R
BVMT-R
RBANS

If I'm being a bit retentive on norms, I might give visual reproduction and logical memory from WMS (because they're normed together). . .

caveat - I haven't seen the WMS-IV yet.

Just wanted to say that I really love the DKEFS, although I really want to see norms for frontal or TBI patients for it. Nonethless, I think its gives tons and tons of useful info. My supervisor has us giving the whole thing, even in dementia evals.

JS:
I use WMS-IV now and think its too big and akwardand dont like that they eliminated the 2nd story repitition. Is it really an improvement? The other tasks seem interesting, but frankly, with everything else I need to get done in my evals, we pretty much stick with LM and VM only. Im sure you have heard some of the slander from collegues, what are they say? Wat do you make of it?

 

[Neuropsych2be]

*cough* Rorschach *cough* Ham-D in pharma research *cough* etc.

The WMS is unfortunately not very practical for clinicians who have limited time to complete an assessment. I use parts of the WMS, but I can't tell you the last time I gave it front to back....probably when I first learned it in graduate school. Even if I have a psych tech administer everything, it usually isn't worth the time.

I actually like the Rorschach but for the life of me I can't understand why the Hamilton is used in pharma research. Charles Nemeroff at Emory appeared to use the Hamilton almost exclusively and I have read criticisms that this instrument ended up giving the answers he sought. A case of a poorly designed test being chosen for reasons that have little to do with good methodology I suppose. Of course, the same has been said of the Rorschach 🙂