Teleneuropsychology: normative data for the assessment of memory in online settings.

INTRODUCTION: The COVID-19 pandemic has forced significant changes in clinical practice. Psychologists and neuropsychologists had to modify their settings to assess patients' abilities, switching from an in-person modality to a remote setting by using video calling platforms. Consequently, this change brought about the need for new normative data tailored to remote settings. AIM AND METHODS: The study aimed to develop normative data for the online assessment of neuropsychological memory tests and to compare it with the published norms obtained in standard settings. Two hundred and four healthy Italian volunteers performed three verbal memory tests through the Google Meet platform: the Digit Span (Backward and Forward), the Rey Auditory Verbal Learning, and the Verbal Paired Associated Learning Test. RESULTS: This research provides specific norms that consider the influence of demographic characteristics. Their comparison with published norms shows a medium to high agreement between systems. The present study provides a reference for the clinical use of neuropsychological instruments to assess verbal memory in a remote setting and offers specific recommendations.

The neurocognitive implications of depression and socioeconomic status in people with HIV.

OBJECTIVE: This cross-sectional study investigates the independent and interactive effects of depression and socioeconomic status (SES) on neurocognition in a diverse sample of people with HIV (PWH). METHOD: The sample of 119 PWH (71% Latinx, 27% female) completed comprehensive neurocognitive and psychosocial evaluations and were separated into two groups: those with a history of depression diagnosis (n = 47) and those without (n = 72). RESULTS: The results of regression analyses indicated that lifetime depression was not associated with lower SES nor with worse neurocognitive performance on any neurocognitive outcome. However, a significant main effect of SES was observed on the Hopkins Verbal Learning Test (total), indicating that higher SES was associated with better verbal learning performance (B= .11, SE = .05, p< .02). Lastly, the results revealed an interactive effect of lifetime depression and SES, such that individuals with depression and higher SES performed better on tests of attention/working memory (i.e., WAIS-III Letter-Number Sequencing, B= .08, SE = .04, p< .02; Paced Auditory Serial Addition Test, B= .39, SE = .16, p< .02). CONCLUSIONS: Depression and SES appear to play an important role in the neurocognitive performance of PWH. Specifically, higher SES appears to have a protective effect on attention/working memory among PWH only if they have co-morbid history of lifetime depression.

Increased Financial Altruism is Associated with Alzheimer's Disease Neurocognitive Profile in Older Adults.

BACKGROUND: Older age is associated with an increase in altruistic behaviors such as charitable giving. However, few studies have investigated the cognitive correlates of financial altruism in older adults. OBJECTIVE: This study investigated the cognitive correlates of financial altruism measured using an altruistic choice paradigm in a community-based sample of older adults. METHODS: In the present study, a sample of older adults (N = 67; M age = 69.21, SD = 11.23; M education years = 15.97, SD = 2.51; 58.2% female; 71.6% Non-Hispanic White) completed a comprehensive neuropsychological assessment and an altruistic choice paradigm in which they made decisions about allocating money between themselves and an anonymous person. RESULTS: In multiple linear regression analyses that controlled for age, education, and sex, financial altruism was negatively associated with performance on cognitive measures typically sensitive to early Alzheimer's disease (including word list learning and recall, delayed story recall, and animal fluency). CONCLUSION: Findings of this study point to a negative relationship between financial altruism and cognitive functioning in older adults on measures known to be sensitive to Alzheimer's disease. Findings also point to a potential link between financial exploitation risk and Alzheimer's disease in older age.

Dynamic assessment of multilingual children's word learning.

BACKGROUND: Teachers and clinicians may struggle to provide early identification to support multilingual children's language development. Dynamic assessments are a promising approach to identify and support children's language development. AIMS: We developed and studied a novel word learning task that is dynamic and language neutral. It makes use of multilingual children's abilities to apply language transfer, fast mapping and socially embedded language to the learning of new words. METHODS & PROCEDURES: A total of 26 children attending kindergarten in French participated in this study. Within this group, 13 different home languages were spoken. Children took part in a dynamic assessment task of their word learning that consisted of a test-teach-retest task. Children's scores on this task were compared with their language abilities reported by their parents, amount of language exposure and scores on standardized tests of vocabulary. All tasks were delivered in French. OUTCOMES & RESULTS: Children had higher accuracy for known words as compared with new words in the task, which may suggest transfer of knowledge from their first language. They also showed increased accuracy in identifying and naming the new words across the three trials, suggesting fast mapping of these new vocabulary items. Finally, the scores on the dynamic task correlated to children's vocabulary scores on the standardized tests, but not parent report of language development, or the amount of exposure to the language of school. CONCLUSIONS & IMPLICATIONS: This novel dynamic assessment task taps into the process of vocabulary learning, but is less influenced by prior language knowledge. Together, these findings provide insight into early word learning by young multilingual children and proposes a conceptual model for identifying strategies to support second language acquisition. WHAT THIS PAPER ADDS: What is already known on the subject Many barriers exist with regards to assessing the language abilities of multilingual children when a clinician aims to assess their language abilities in both languages. An alternative approach is to measure children's language processing abilities. What this paper adds to existing knowledge A novel dynamic and multilingual task was developed and implemented in this study. This task builds on children's word learning abilities that include cross-language transfer, fast-mapping, and socially imbedded learning. This multilingual task was found to tap into vocabulary learning but was not influenced by prior language knowledge. What are the potential or actual clinical implications of this work? Applying a task that focuses on language processing abilities is a promising strategy to capture language abilities in multilingual children. In addition, the dynamic nature of this tasks allows a clinician to identify scaffolding strategies that best support children's word learning.

Toddlers link social and speech variation during word learning.

Within a language, there is considerable variation in the pronunciations of words owing to social factors like age, gender, nationality, and race. In the present study, we investigate whether toddlers link social and linguistic variation during word learning. In Experiment 1, 24- to 26-month-old toddlers were exposed to two talkers whose front vowels differed systematically. One talker trained them on a word-referent mapping. At test, toddlers saw the trained object and a novel object; they heard a single novel label from both talkers. Toddlers responded differently to the label as a function of talker. The following experiments demonstrate that toddlers generalize specific pronunciations across speakers of the same race (Experiment 2), but not across speakers who are simply an unfamiliar race (Experiment 3). They also generalize pronunciations based on previous affiliative behavior (Experiment 4). When affiliative behavior and race are pitted against each other, toddlers' linguistic interpretations are more influenced by affiliative behavior (Experiment 5). These experiments suggest that toddlers attend to and link social and speech variation in their environment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Testing measurement equivalence of neurocognitive assessments across language in the Hispanic Community Health Study/Study of Latinos.

OBJECTIVE: Neuropsychological instruments are often developed in English and translated to other languages to facilitate the clinical evaluation of diverse populations or to utilize in research environments. However, the psychometric equivalence of these assessments across language must be demonstrated before populations can validly be compared. METHOD: To test this equivalence, we applied measurement invariance procedures to a subsample (N = 1,708) of the Hispanic Community Health Survey/Study of Latinos (HCHS/SOL) across English and Spanish versions of a neurocognitive battery. Using cardinality matching, 854 English-speaking and 854 Spanish-speaking subsamples were matched on age, education, sex, immigration status (U.S. born, including territories, or foreign-born), and Hispanic/Latino heritage background. Neurocognitive measures included the Six-Item Screener (SIS), Brief-Spanish English Verbal Learning Test (B-SEVLT), Word Fluency (WF), and Digit Symbol Substitution (DSS). Confirmatory factor analysis was utilized to test item-level invariance of the SIS, B-SEVLT, and WF, as well as factor-level invariance of a higher-order neurocognitive functioning latent variable. RESULTS: One item of both the SIS and WF were more difficult in Spanish than English, as was the DSS test. After accounting for partial invariance, Spanish-speakers performed worse on each of the subtests and the second-order neurocognitive functioning latent variable. CONCLUSIONS: We found some evidence of bias at both item and factor levels, contributing to the poorer neurocognitive performance of Spanish test-takers. While these results explain the underperformance of Spanish-speakers to some extent, more work is needed to determine whether such bias is reflective of true cognitive differences or additional variables unaccounted for in this study. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Probing the Role of a Regional Quantitative Assessment of Amyloid PET.

BACKGROUND: In clinical practice, the amy-PET is globally inspected to provide a binary outcome, but the role of a regional assessment has not been fully investigated yet. OBJECTIVE: To deepen the role of regional amyloid burden and its implication on clinical-neuropsychological features. MATERIALS: Amy-PET and a complete neuropsychological assessment (Trail Making Test, Rey Auditory Verbal Learning Test, semantic verbal fluency, Symbol Digit, Stroop, visuoconstruction) were available in 109 patients with clinical suspicion of Alzheimer's disease. By averaging the standardized uptake value ratio and ELBA, a regional quantification was calculated for each scan. Patients were grouped according to their overall amyloid load: correlation maps, based on regional quantification, were calculated and compared. A regression analysis between neuropsychological assessment and the regional amyloid-ß (Aß) load was carried out. RESULTS: Significant differences were observed between the correlation maps of patients at increasing levels of Aß and the overall dataset. The Aß uptake of the subcortical gray matter resulted not related to other brain regions independently of the global Aß level. A significant association of semantic verbal fluency was observed with ratios of cortical and subcortical distribution of Aß which represent a coarse measure of differences in regional distribution of Aß. CONCLUSION: Our observations confirmed the different susceptibility to Aß accumulation among brain regions. The association between cognition and Aß distribution deserves further investigations: it is possibly due to a direct local effect or it represents a proxy marker of a more aggressive disease subtype. Regional Aß assessment represents an available resource on amy-PET scan with possibly clinical and prognostic implications.

Development and assessment of a verbal response scale for the Patient-Specific Functional Scale (PSFS) in a low-literacy, non-western population.

PURPOSE: The Patient-Specific Functional Scale (PSFS) is a routinely used measure of physical function with a 0-10 response scale. We aimed to develop verbal response options for the PSFS, pre-test it for use in a multilingual, low-literacy country- Nepal, and compare preference and error rates between numeric and verbal scale. We hypothesized that a verbal scale would be preferred by respondents and yield fewer errors. METHOD: We interviewed 42 individuals with musculoskeletal, neurological, and cardiopulmonary conditions to understand how people describe varying levels of physical ability. Transcripts were thematically analyzed, and through consensus, we developed two sets of verbal responses for the PSFS. Next, we pre-tested the scales on an additional 119 respondents following which participants were asked to specify their preferred scale. Error rates were analyzed retrospectively using pre-specified criteria. RESULTS: Participants described their ability in terms of the quality (95%) and the quantity of task performance (88%). Although the verbal scales were preferred over the numeric scale (50% versus 12%), there was no significant difference in error rates between numeric (34%) and verbal scales (32% and 36%). Higher error rates were associated with greater age, fewer years of education, and inexperience with numeric scales. CONCLUSION: Despite a higher preference for verbal scale, 1 out of 3 patients made errors in using the PSFS, even with an interview format. The error rates were higher among participants with low literacy. The findings raise questions about the utility of PROMs in countries with low literacy rates.

Brief Report: Socioeconomic Factors Associated with Minimally Verbal Status in Individuals with ASD.

About 30% of adults with autism are minimally verbal. Past research suggested that after age five, few gain verbal fluency, but studies have rarely investigated whether family environmental factors contribute to the acquisition of verbal fluency. The present study utilized data from the Autism Diagnostic Interview-Revised to compare changes in verbal fluency for 404 individuals with autism from childhood to adolescence and adulthood. Socioeconomic factors were examined across fluency groups (i.e., those who did/did not achieve verbal fluency). Findings indicated that fully 60% of those who were minimally verbal in early childhood acquired verbal fluency in adolescence and adulthood. Parent socioeconomic status differed across fluency groups, suggesting the importance of environmental factors for individual development.

Stress Is Associated With Neurocognitive Function in Hispanic/Latino Adults: Results From HCHS/SOL Socio-Cultural Ancillary Study.

OBJECTIVES: The purpose of this study was to evaluate the hypothesis that chronic and acculturative stress would be negatively associated with neurocognitive function among middle aged to older Hispanics/Latinos. METHOD: Our analytic sample consisted of 3,265 participants (mean age = 56.7 (±0.24)) from the Hispanic Community Health Study/Study of Latinos who participated in its Sociocultural Ancillary Study. During the baseline phase of this project, participants were assessed on multiple domains of neurocognitive function, and completed self-report measures of chronic and acculturative stress. RESULTS: Each standard deviation increase in chronic stress was associated with lower performance in a verbal learning task (B = -.17, 95% CI [-.32, -.01]); this association was no longer significant after adjusting for mental and physical health symptoms, including depression and anxiety symptoms, and cardiovascular health. A standard deviation increase in acculturative stress was associated with poorer performance in all cognitive measures (Bs range = -.13 to -1.03). Associations of acculturation stress with psychomotor speed, verbal learning, and word fluency remained significant after adjusting for mental and physical health symptoms. DISCUSSION: Our results suggest that mental and physical health may help explain some cross-sectional associations between stress and cognition and highlight the need to examine culture-specific psychosocial stressors to better understand the context of psychosocial risk factors for neurocognitive performance.

Verbal Learning Mediates the Relationship Between Executive Functions and a Laboratory Task of Medication Management in HIV Disease.

OBJECTIVE: Impairments in executive functions and learning are common in HIV disease and increase the risk of nonadherence to antiretroviral therapy. The mixed encoding/retrieval profile of HIV-associated deficits in learning and memory is largely driven by dysregulation of prefrontal systems and related executive dysfunction. This study tested the hypothesis that learning may be one pathway by which executive dysfunction disrupts medication management in people living with HIV (PLWH). METHOD: A total of 195 PLWH completed a performance-based laboratory task of medication management capacity and clinical measures of executive functions, verbal learning and memory, and motor skills. RESULTS: Executive functions were significantly associated with verbal learning and medication management performance. In a model controlling for education, learning significantly mediated the relationship between executive functions and medication management, and this mediation was associated with a small effect size. In particular, executive dysfunction was associated with diminished use of higher-order learning strategies. Alternate models showed that executive functions did not mediate the relationship between learning and medication management nor did motor skills mediate the relationship between executive functions and medication management. CONCLUSIONS: PLWH with executive dysfunction may demonstrate difficulty in learning new information, potentially due to ineffective strategy use, which may in turn put them at a higher risk for problems managing their medications in the laboratory. Future studies may wish to investigate whether compensatory neurocognitive training (e.g., using more effective learning strategies) may improve medication management among PLWH.

Nutrition, Immigration and Health Determinants Are Linked to Verbal Fluency among Anglophone Adults in the Canadian Longitudinal Study on Aging (CLSA).

OBJECTIVES: Later-life cognitive impairment is an important health issue; however, little is known about the condition among diverse groups such as immigrants. This study aims to examine whether the healthy immigrant effect exists for verbal fluency, an indicator of cognitive functioning, among anglophone middle-aged and older adults in Canada. METHODS: Using from the baseline data of the Canadian Longitudinal Study on Aging (CLSA), multiple linear regression was employed to compare associations among immigrants (recent and long-term) and Canadian-born residents without dementia for two verbal fluency tests, the Controlled Oral Word Association Test (COWAT) and the Animal Fluency (AF) task. Covariates included socioeconomic, physical health, and dietary intake. RESULTS: Of 8,574 anglophone participants (85.7% Canada-born, 74.8% aged 45-65 years, 81.8% married, 81.9% with a post-secondary degree), long-term immigrants (settled in Canada >20 years) performed significantly better than Canadian-born residents for the COWAT (42.8 vs 40.9) but not the AF task (22.4 vs 22.4). Results of the multivariable adjusted regression analyses showed that long-term immigrants performed better than Canadian-born peers in both the COWAT (B=1.57, 95% CI: 0.80-2.34) and the AF test (B=0.57, 95% CI: 0.19-0.95), but this advantage was not observed among recent immigrants. Other factors associated with low verbal fluency performance included being single, socioeconomically disadvantaged, having hypertension, excess body fat, and consuming low amounts of pulses/nuts or fruit/vegetables. CONCLUSIONS: Long-term immigrants had higher verbal fluency test scores than their Canadian-born counterparts. Immigration status, social, health and nutritional factors are important considerations for possible intervention and prevention strategies for cognitive impairment.

Which measure of socioeconomic status best predicts bilingual lexical abilities and how? A focus on four-year-olds exposed to two majority languages.

This study evaluates the ability of different measures of socioeconomic status (SES) to predict lexical outcomes for preschoolers raised in a context of nationwide bilingualism. The participants were 58 children aged 3;11-4;3 from Maltese-dominant homes who attended state preschools. Receptive picture name judgement and picture naming, in Maltese and English, were employed to measure receptive and expressive lexical abilities, respectively. Lexical outcomes for four individual SES variables and a single composite SES measure were similar but not directly interchangeable. The composite SES variable emerged as most strongly predictive of children's lexical performance. Receptive judgement of phonological accuracy improved similarly in both languages with higher composite SES. Naming skills increased significantly in English but not in Maltese, suggesting differences in English input related to parental SES. A focus on SES in relation to lexical skills in two majority languages is novel and adds to current understanding of normative bilingual acquisition.

The "SuperAgers" construct in clinical practice: neuropsychological assessment of illiterate and educated elderly.

INTRODUCTION: The demographic transition is a global event intensified during the last decades that represents population aging. Thus, the studies directed to the elderly 80 years of age or more with preserved cognitive functions (named SuperAgers) emerges as a possible path to full comprehension of the health of those aging with acceptable levels of functionality and independency. OBJECTIVE: To evaluate the cognitive performance of the elderly over 80 years old, associating the results to their educational level. METHOD: We evaluated 144 healthy elders with 80 years or more through the following cognitive tests Mini-Mental State Examination (MMSE), Cambridge Cognitive Examination (CAMCOG), Clock Drawing Test (CDT), and Verbal Fluency Test (VF) and compared the tests' scores with their educational level segmented in years of formal education, being the groups ILLITR (<1 year of schooling), 1TO4 (from 1 to 4 years of schooling), and 5MORE (>5 years of schooling). RESULTS: There was positive influence of educational level on the cognitive tests' score, which indicates higher cognitive reserve of the elderly with higher educational levels. CONCLUSION: The functionality and independence of the so-called SuperAgers is determined by the cognitive reserve acquired throughout life, mainly developed by the years of formal education.

The Classification Accuracy of a Dynamic Assessment of Inferential Word Learning for Bilingual English/Spanish-Speaking School-Age Children.

Purpose Educators often use results from static norm-referenced vocabulary assessments to aid in the diagnosis of school-age children with a language disorder. However, research has indicated that many of these vocabulary assessments yield inaccurate, biased results, especially with culturally and linguistically diverse children. This study examined whether the use of a dynamic assessment of inferential word learning was more accurate at identifying bilingual (English/Spanish-speaking) children with a language disorder when compared to static measures of vocabulary. Method Thirty-one bilingual Spanish/English school-age children-21 children with typical language and 10 children with a language disorder-ages 5;9-9;7 (years;months) were administered traditional static vocabulary assessments and a dynamic assessment of inferential word learning that used a test-teach-test design. Results Discriminant analysis and logistic regression indicated that the combined posttest scores and modifiability ratings from the dynamic assessment generated 90%-100% sensitivity and 90.5%-95.2% specificity, which were superior to the static vocabulary tests. Conclusion These preliminary findings suggest that dynamic assessment of inferential word learning may be an effective method for accurately identifying diverse children with a language disorder.

Forward to the past: Revisiting the role of immediate recognition in the assessment of episodic memory.

Introduction: During the clinical assessment of episodic memory, encoding ability is typically inferred from immediate recall performance. This dependency on effortful retrieval may not be optimal for estimating encoding, particularly in the presence of executive dysfunction. We examined whether a test of immediate recognition memory could meaningfully supplement recall in estimating encoding and provide unique information about memory retention.Method: Fifty older adult outpatients were administered a neuropsychological test battery including original and revised versions of the Hopkins Verbal Learning Test; the former (HVLT) assesses recognition memory immediately after learning trials, while the latter (HVLT-R) assesses only delayed recognition. Hierarchical regressions evaluated the incremental value of immediate recognition in predicting both delayed verbal and visual recognition. ANCOVA was performed on subgroups defined by the number of impaired performances on executive functioning tests (EF-intact, EF-1, EF-2) to examine the influence of executive impairment on measures of immediate recall and recognition. Recall- and recognition-based estimates of verbal memory retention were also compared across groups to determine whether they yield distinct patterns of memory consolidation.Results: Immediate verbal recognition accounted for significant variance in both delayed verbal and visual recognition beyond immediate recall, age, and education. Although subgroups were demographically similar, EF-1 and EF-2 performed significantly worse than EF-intact across verbal and visual memory recall. Contrastingly, there were no group differences in immediate recognition. Subgroups attained similar scores on a conventional, recall-based memory retention measure, but EF-2 showed relatively greater forgetting on a recognition-based retention measure.Conclusions: Immediate verbal recognition is an independent determinant of delayed memory performance but is not captured in current test paradigms. Study results provide proof-of-concept that recognition testing at learning can provide a more comprehensive index of encoding ability than recall alone, may facilitate disentangling memory functions from executive deficits, and could have important downstream implications for estimating memory consolidation.

Women Outperform Men in Verbal Episodic Memory Even in Oldest-Old Age: 13-Year Longitudinal Results of the AgeCoDe/AgeQualiDe Study.

BACKGROUND: Sex differences in verbal episodic memory function have been widely reported. However, sex-specific effects on rates of episodic memory decline remain controversial, and evidence is particularly scarce in the oldest-old population. OBJECTIVE: We aimed to investigate sex differences in trajectories of episodic memory performance in oldest-old individuals. METHODS: Based on 13-year longitudinal data with 9 follow-up assessments of a large sample of cognitively unimpaired old (75+) primary care patients (n = 3,254) participating in the German AgeCoDe/AgeQualiDe study, we used linear mixed effects analyses to model sex-specific trajectories of change in verbal episodic memory while accounting for covarying factors. RESULTS: We found that even in the highest age group women outperformed men in immediate (b = -1.71, p < 0.001) and delayed (b = -0.85, p < 0.001) free recall conditions. Associated late-life trajectories, however, did not differ significantly between the sexes. We further demonstrated that younger age, higher education, and an absence of depressive symptoms predicted better performance in both sexes. In contrast, past occurrences of stroke and APOE ɛ4 carrier status showed a negative relation to test scores. CONCLUSION: Our findings confirm previous research suggesting that women perform better in verbal episodic memory tests. We add that this advantage is still present in the oldest-old age groups. Our results indicate that sociodemographic and health related factors are as important as genetically based APOE ɛ4 carrier status in the prediction of normal cognitive development in advanced old age.

Examining Performance on a Process-Based Assessment of Word Learning in Relation to Vocabulary Knowledge and Learning in Vocabulary Intervention.

Vocabulary knowledge of young children, as a well-established predictor of later reading comprehension, is an important domain for assessment and intervention. Standardized, knowledge-based measures are commonly used by speech-language pathologists (SLPs) to describe existing vocabulary knowledge and to provide comparisons to same-age peers. Process-based assessments of word learning can be helpful to provide information about how children may respond to learning opportunities and to inform treatment decisions. This article presents an exploratory study of the relation among vocabulary knowledge, word learning, and learning in vocabulary intervention in preschool children. The study examines the potential of a process-based assessment of word learning to predict response to vocabulary intervention. Participants completed a static, knowledge-based measure of vocabulary knowledge, a process-based assessment of word learning, and between 3 and 11 weeks of vocabulary intervention. Vocabulary knowledge, performance on the process-based assessment of word learning, and learning in vocabulary intervention were strongly related. SLPs might make use of the information provided by a process-based assessment of word learning to determine the appropriate intensity of intervention and to identify areas of phonological and semantic knowledge to target during intervention.

The Effects of Vocabulary Enhancement Exercises and Group Dynamic Assessment on Word Learning Through Lexical Inferencing.

The study aimed to explore the effect of group dynamic assessment on word learning through lexical inferencing and to compare it to that of vocabulary enhancement exercises. Through purposive sampling, 45 intermediate EFL learners were selected as participants and randomly assigned to three groups. The participants read six texts over a 6-day period and answered comprehension questions for each text. In the second phase of each treatment session, the first group engaged in lexical inferencing of the underlined words within group dynamic assessment framework. The second group did two vocabulary exercises for each target word. The third group engaged in lexical inferencing of target words through group dynamic assessment framework and also did one vocabulary exercise for each target word. Vocabulary Knowledge Scale (Wesche and Paribakht in Can Mod Lang Rev 53:13-40, 1996) was used to measure learners' knowledge of the target words 1 day prior to the treatment and 1 day and 28 days after the treatment. The results showed that in terms of gains in depth and size of vocabulary knowledge the first and the second groups were not significantly different. However, the third group significantly outperformed the first and the second groups. It was concluded that group dynamic assessment is as effective as vocabulary exercises in enhancing word learning through lexical inferencing and that the combination of group dynamic assessment and vocabulary exercises could enhance word learning through lexical inferencing even more.

Brief and cost-effective tool for assessing verbal learning in multiple sclerosis: Comparison of the Rey Auditory Verbal Learning Test (RAVLT) to the California Verbal Learning Test - II (CVLT-II).

BACKGROUND: The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) is a common cognitive screening tool. However, administration and scoring can be time-consuming, and its use of proprietary subtests like the California Verbal Learning Test - II (CVLT-II) is financially limiting. Use of the non-proprietary Rey Auditory Verbal Learning Test (RAVLT) may be provide a valid alternative. OBJECTIVES: To compare the RAVLT and CVLT-II in terms of diagnostic accuracy for detecting cognitive impairment, and to determine optimal cut-scores for the RAVLT. METHODS: 100 participants with MS completed the five learning trials from the RAVLT and CVLT-II. Receiver operating characteristic analyses were used to compare the measures' sensitivities, specificities, positive predictive values (PPV) and negative predictive values (NPV), and to identify optimal cut-scores. RESULTS: Using a criterion of 1.5 SD below the normative sample mean, the RAVLT showed fair to good (κs = 0.21-0.41) agreement with the CVLT-II. A cut-score of 12 on Trials 1 + 2 of the RAVLT showed fair sensitivity (75%) and specificity (76%) and did not differ significantly from the CVLT-II (p > .05). CONCLUSIONS: Performance on initial learning trials of the RAVLT may provide a brief, valid, and cost-effective alternative to the CVLT-II for screening verbal learning impairments in MS.