Functional cooking skills and neuropsychological functioning in patients with stroke: an ecological validity study.

Efforts to relate neuropsychological performance to real-world task functioning have predominantly yielded lackluster results, typically with neuropsychological performance accounting for modest amounts of variance in function. Nonetheless, the ecological validity of neuropsychological measures for predicting functional abilities remains a strong research interest and clinical necessity. This study relates neuropsychological performance to performance on a standardised cooking task (Rabideau Kitchen Evaluation - Revised; RKE-R) in persons with stroke. Results showed that while the composite score of mean neuropsychological performance had the largest association with meal preparation, several neuropsychological measures were significantly related to the RKE-R. Groups of left and right hemisphere stroke patients were not significantly different in terms of RKE-R performance. These results suggest that functional cooking task performance is related to intact cognitive abilities in delayed verbal memory, simple auditory attention, and visuospatial skills, as well as overall cognitive performance. Implications for neuropsychologists are discussed.

Potential for interpretation disparities of Halstead-Reitan neuropsychological battery performances in a litigating sample.

The performances of 110 litigants on seven variables from the Halstead-Reitan neuropsychological battery (HRNB) were used to compare Heaton, Miller, Taylor, and Grant's (2004) Deficit Scale (DS) and Reitan and Wolfson's (1993) Neuropsychological Deficit Scale (NDS). Additional comparisons were made for people who passed or failed the Test of Memory Malingering (TOMM) to determine effects of effort on scores generated by either scoring system. Wilcoxon signed-rank tests revealed that all seven comparisons were significantly different for the full sample (p< or =0.001). The NDS indicated greater levels of impairment compared to DS across all variables. These findings were also obtained when considering effort, though TOMM failure was related to non-significant differences for two variables. These findings suggest that the two scoring systems are not equivalent, with Heaton et al.'s DS resulting in consistently higher identification rates of normal brain functioning compared to those generated from Reitan and Wolfson's NDS system.

"Cognitive impairment associated with toxigenic fungal exposure": a critique and critical analysis.

Recently Gordon et al. (2004) reported the results of a study relating exposure to toxigenic fungi to cognitive impairment. A number of methodological problems limit the utility of this study, including the authors' not examining a number of potential confounding variables, use of a mild traumatic brain injury group as a comparison, and problematic statistical analyses increasing the Type 1 error rate. Based on these limitations, the authors' conclusion that mold-exposed people have more cognitive and physical symptoms than normal controls is questionable at best. This critique describes some of the problems with the methodology employed and the related difficulty in drawing conclusions from their work.

Effects of parental presence and child characteristics on children's neuropsychological test performance: third party observer effect confirmed.

An observer's presence during neuropsychological testing can impair task performance in adults, but this phenomenon has yet to be examined as it pertains to neuropsychological testing of children. The current study focused on parental presence effects on nonverbal intelligence and verbal learning performance of children aged 6 to 8 years. Each of 53 children completed one form of the Test of Nonverbal Intelligence-3rd Edition (TONI-3) and the Selective Reminding Test (SRT) with his/her parent in the room and an alternate form of each with only the experimenter with the child in the testing room. Of several possible covariates, only the child's age was significant and included in final analyses. Using a doubly multivariate MANCOVA it was discovered that parent's observation status significantly interacted with the order of observation to impact task performance. This significant effect can mainly be attributed to a steeper positive slope (i.e., children's greater improvement over time) for TONI-3 T scores in children whose parent observed first; children whose parents were absent for the first half of testing improved to a lesser extent over time. No significant relationship was found between observation and SRT scores. These results lend some support to the assertion of previous studies that the presence of third party observers may affect the validity of neuropsychological test results.

Regulations governing the out-of-state practice of psychology: implications for forensic neuropsychologists.

Many states allow psychologists licensed in other jurisdictions to practice temporarily without obtaining a full license. However, both the restrictions of practice and the procedures required before practice is allowed vary extensively among states. This article examines the regulations of U.S. and Canadian territories governing temporary practice of nonresident psychologists. Current licensing laws were obtained from each state's respective psychological board or related Web sites from May to July 2004. Results highlighted vast regulatory and procedural differences for temporary practice among jurisdictions. Due to the degree of variability in each jurisdiction's regulations governing, caution must be taken so that psychologists comply with up-to-date guidelines before practicing outside of the regions in which they are licensed. The out-of-state psychologist must contact the appropriate state or provincial licensing board for guidelines and pertinent regulation.

An examination of the California Verbal Learning Test II to detect incomplete effort in a traumatic brain-injury sample.

Clinical neuropsychologists are frequently called on to distinguish people who appear impaired on neuropsychological testing due to putting forth incomplete effort from those who have genuine cognitive deficits. Because traditional measures of effort are becoming accessible over the Internet and within the legal community and their purpose may be obvious to potential malingerers, nontraditional effort measures have been newly investigated. Using discriminant function analysis, this study explores whether five California Verbal Learning Test-Second Edition (CVLT-II) variables could differentiate between head-injured patients who were putting forth full effort and those who were putting forth incomplete effort. The discriminant function seemed to best predict those who put forth adequate effort while testing (95.6% correct) but not those who failed to put forth adequate effort during testing (only 13.8% correct). Hence, although the overall classification rate was moderately impressive (75.8%), the model's sensitivity in classification of the incomplete effort group was low. Cautious applications for these findings are discussed.