Empirically derived ability-achievement subtypes in a clinical sample.

The purpose of the present study was to identify reliable and clinically meaningful patterns of ability and achievement using the WISC-III and WIAT. Cluster analysis was used to group the 182 WISC-III and WIAT profiles (10 WISC-III subtests and 4 WIAT subtests) of children between the ages of 9 and 14 years. Theoretical and empirical considerations were used to identify a cluster solution, which involved comparison of several five-, six- and eight-cluster solutions. A five-cluster solution was selected as being representative of the data, which was well replicated across three hierarchical clustering methods (i.e., complete linkage, average linkage-within groups, and average linkage-between groups (UPGMA)). The clusters were labeled based on their most salient characteristics, which included a group of predominantly low ability and achievement, a group demonstrating a pattern of verbal processing deficits, a group demonstrating a pattern of visual spatial/processing speed deficits, a group with low ability and achievement with average processing speed, and a group with deficits consistent with an ACID pattern. The external validity of the five subtypes was assessed through an evaluation of the relationship between cluster membership and neuropsychological test data. Most predictions regarding neuropsychological performance were supported by the data, providing further evidence of the validity of the five-cluster solution. Clinical implications of the ability-achievement typology and suggestions for future research are discussed.     

WISC-III Cognitive Profiles in Children with ADHD: Specific Cognitive Impairments and Diagnostic Utility

This study aimed to investigate the presence of specific cognitive impairments and the diagnostic utility of the WISC-III in children with ADHD. Ninety-eight children with ADHD and 81 children without ADHD matched by age and gender (control group), between the ages of 6 and 12?years, participated in the study. Children with ADHD revealed the most pronounced deficits in the subtests tapping working memory and processing speed. Freedom from Distractibility was the cognitive profile most impaired and that showed the highest diagnostic accuracy to discriminate children with ADHD. The optimal cutoff scores of the most common WISC-III cognitive profiles revealed greater diagnostic accuracy than the traditional approach of full or partial profiles. Taken together, these results suggested that in the context of a comprehensive psychological assessment, the WISC may provide knowledge about the specific cognitive strengths and weaknesses that characterize this disorder and may be useful in the decision-making process relative to ADHD diagnosis.     

Construct validity of the Bender-Gestalt II: comparison with Wechsler Intelligence Scale for Children-III

This study investigated the relationships of visuomotor constructs as measured by the Bender-Gestalt II with the subtests of the WISC-III. A factor analysis included the standardized Copy and Recall scores of the Bender-Gestalt II and subtest scores of the WISC-III. The Copy score was predicted to load on measures of visual and spatial thinking and the Recall score on a short-term memory factor. The results of a principal components analysis suggest a four-factor solution with the Bender-Gestalt II Copy score loading on a visual and spatial thinking factor primarily with WISC-III Perceptual Organization subtests. The Recall score loaded on a visual and spatial thinking factor as well as a short-term memory factor with the WISC-III Digit Span subtest. The results suggest the Bender-Gestalt II Copy subtest shared commonality with the visual and spatial tasks given the similarity in the visuomotor demands of each test and was less influenced by processing speed or cultural knowledge than other tests on the visual and spatial thinking factor. Also, results suggest Bender-Gestalt II Recall measures elements of both visual and spatial thinking as well as aspects of short-term memory and memory retrieval. Clinical guidelines for co-administration and underlying processing demands are discussed.     

An evaluation of differential prediction of WIAT achievement scores from WISC-III FSIQ across ethnic and gender groups

This study examines differential prediction of WIAT achievement scores based on WISC-III FSIQ in white as compared with African American and Hispanic children, and in females as compared with males. A procedure which allows simultaneous comparisons of slopes and intercepts across groups is employed. The results are consistent with previous research findings in supporting the general absence of bias in predicting achievement from IQ.     

Test of the definition of learning disability based on the difference between IQ and achievement

A learning disability is commonly defined as a discrepancy between IQ and achievement. This has been criticized for identifying too many children as having a learning disability who have high IQs and average academic achievement. Such overidentification as actually occurred was assessed in 473 referred children (8-16 years, M= 10, SD=2) with normal intelligence. Learning disability was defined as a significant discrepancy (p<.05) between predicted and obtained achievement in reading, mathematics, or written expression on the Wechsler Individual Achievement Test. Predicted achievement was based on the child's WISC-III Full Scale IQ. Overidentification was considered to occur when a child scored at or above age level in reading, mathematics, and writing but still had a significant discrepancy between predicted and obtained achievement by virtue of a high IQ. Learning disability was diagnosed in 312 (66%) of the children. There was no overidentification because all children had one or more WIAT scores below the normative level for their age, i.e., < 100. Further, only 7% of the children were identified with a learning disability based on a WIAT score in the 90s. These children had a mean IQ of 123 and were rated by their teachers and parents as having learning problems.     

Rater Agreement on IQ and Achievement Tests: Effect on Evaluations of Learning Disabilities

Protocols from 110 evaluations utilizing the Wechsler Intelligence Scale for Children-Third Edition (WISC-III) and the Woodcock/Johnson Tests of Achievement-Revised (W/J-R) were scored by two different raters to determine (a) whether subtests with more difficult levels of scoring yield lower interrater correlation coefficients, (b) whether scoring errors on subtests affect broad score estimates, (c) the effect of expertise of rater on scoring errors, and (d) whether scoring errors affect a learning disability determination based on IQ/achievement discrepancy. Scoring errors were found on almost 25% of Comprehension and Vocabulary subtests; however, the effect of these scoring errors was minimal. About 42% of Writing Samples subtests had scoring errors, resulting in a mean change of 1.75 points on the Broad Written Language Cluster subtest. On the WISC-III, but not the W/J-R, there were significantly more errors made by inexperienced testers. Scoring errors resulted in two cases in which learning disability determination would be changed. Overall, the study corroborates previous findings of strong interrater reliability on most subtests of common IQ and achievement tests and indicates that novice scorers are not likely to make scoring mistakes that will significantly impact an IQ/achievement discrepancy-based documentation of learning disability.     

Criterion-related bias with the guide to the assessment of test-session behavior for the WISC-III and WIAT: Possible race/ethnicity, gender, and SES effects

Using the Guide to the Assessment of Test-Session Behavior for the WISC-III and WIAT (GATSB), Anglo examiners recorded test observations for 969 children between the ages of 6 and 16 years. The children came from the standardization and validity-study samples of GATSB ratings completed with the Wechsler Intelligence Scale-Third Edition (WISC-III) (Wechsler, 1991). The sample differed by race (Anglo, black, Latino), socioeconomic status (SES) (high, middle, low), and gender. GATSB ratings and WISC-III Verbal, Performance, and Full Scale IQs were compared. Correlations between the GATSB and WISC-III were generally moderate (average R = -.27). Children who exhibited higher levels of avoidance, inattentiveness, and uncooperative behaviors while being tested tended to exhibit lower WISC-III scores. This pattern held true for Anglos, blacks, and Latinos; for girls and boys; and for those from high-, middle-, and low-SES homes. Evidence was generally absent that Anglo examiners display bias in black-Anglo, gender, or SES comparisons. However, consistent differences were noted between Latino and Anglo children. Examiners tended to rate Latinos as displaying better test behaviors than Anglos when children's IQs were below average, but comparable when IQs were average and above. Thus, the GATSB generally displayed similar intrasession validities for children who differ by race/ethnicity, gender, and SES.     

Number processing and calculation in Brazilian children aged 7-12 years

Numerical cognition is based on two components - number processing and calculation. Its development is influenced by biological, cognitive, educational, and cultural factors. The objectives of the present study were to: i) assess number processing and calculation in Brazilian children aged 7-12 years from public schools using the Zareki-R (Battery of neuropsychological tests for number processing and calculation in children, Revised; von Aster & Dellatolas, 2006) in order to obtain normative data for Portuguese speakers; ii) identify how environment, age, and gender influences the development of these mathematical skills; iii) investigate the construct validity of the Zareki-R by the contrast with the Arithmetic subtest of WISC-III. The sample included 172 children, both genders, divided in two groups: urban (N = 119) and rural (N = 53) assessed by the Zareki-R. Rural children presented lower scores in one aspect of number processing; children aged 7-8 years demonstrated an inferior global score than older; boys presented a superior performance in both number processing and calculation. Construct validity of Zareki-R was demonstrated by high to moderate correlations with Arithmetic subtest of WISC-III. The Zareki-R therefore is a suitable instrument to assess the development of mathematical skills, which is influenced by factors such as environment, age, and gender.     

Predictors of neuropsychological test performance after pediatric traumatic brain injury

The influence of neurological and demographic variables on neuropsychological test performance was examined in 100 9-to 16-year-old children with traumatic brain injury (TBI). Regression analyses were conducted to determine the relative contributions of coma, neuroimaging findings, ethnicity, socioeconomic status, and gender to variance in performance on the Wechsler Intelligence Scale for Children-Third Edition (WISC-III), California Verbal Learning Test--Children's Version (CVLT-C), and the Children's Category Test. Both neurological and demographic variables contributed to performance on various WISC-III factor index scores as well as the CVLT-C. No evidence for a moderating effect of demographic variables was found, but speed of information processing mediated the effect of neurological and demographic variables on CLVT-C performance. It is concluded that demographic variables have an incremental effect on the neuropsychological test performance of children with TBI above and beyond the influence of injury severity.     

Discriminant validity of test observations for children with Attention Deficit/Hyperactivity

This paper investigates the discriminant validity of test-session behaviors by comparing whether the observations of children with Attention-Deficit/Hyperactivity Disorder (ADHD) differed from those of unclassified controls. Test-taking behaviors were evaluated according to the Guide to the Assessment of Test Session Behavior for the WISC-III and WIAT (GATSB) (Glutting & Oakland, 1993) following administrations of the Wechsler Intelligence Scale for Children-Third Edition (WISC-III) (Wechsler, 1991). Two groups were compared: an ADHD cohort (n = 49) and children from the GATSB standardization sample (n = 49) matched on the background characteristics of age, race, gender, parent educational attainment, and overall cognitive ability. A multivariate, two-group discriminant function analysis was used to compare groups. Results showed children with ADHD could be differentiated, Wilks &clgr; = .632, F = 18.96, df (3, 94]) p < .001). A classification analysis was used to evaluate the practical utility of the discrimination. The overall hit rate was 80.6% (p < .05), thereby adding to the overall validity of results. Findings suggest that in the course of one-to-one clinical assessments, standardized ratings of children's test behaviors provide useful information about the relative severity of children's inattentive, avoidant, and uncooperative dispositions, and that these factors can affect the magnitude of children's IQs.     

Neuropsychological profile following suicide attempt by hanging: two adolescent case reports.

Hippocampal damage and amnesia following hypoxia and ischemia are described in the few published adult cases of suicide attempt by hanging. However, a recent review (Caine & Watson, 2000) suggests a variable pattern of brain involvement and neuropsychological impairments following hypoxic-ischemic injury that may or may not involve amnesia. To help clarify the impact of hanging on the developing brain, we examined neuropsychological functioning in two adolescents who survived suicide attempt by hanging. Despite differences in Glasgow Coma Scale (GCS), coma duration, and structural imaging findings, both patients had similar IQ (VIQ>PIQ) and presented with various combinations of deficits in expressive/receptive language, visual-constructional and perceptual ability, processing speed, attention, working memory, and/or executive functioning shortly after injury. In spite of their similarities, only one of the patients presented with classic amnesia symptoms in his early recovery. This patient was evaluated 1 year postinjury, and persistent deficits in processing speed and memory encoding were noted. Several hanging-related variables, including longer estimated hanging duration, greater weight, and severe airway edema, were thought to place this patient at increased risk for cognitive deficits. Clinical MRI scans of this patient obtained 6 weeks postinjury revealed mild volume loss as well as abnormalities in bilateral superior cortex. However, CT and MRI scans obtained throughout early recovery did not reveal overt evidence of injury to specific memory-related structures. Comprehensive neuropsychological evaluation of all adolescent survivors of suicide attempt by hanging is recommended, as a variety of postacute cognitive deficits were observed in these patients despite relatively short (相似文献   

Neuropsychological profile of multiple sclerosis

Multiple Sclerosis (MS) is the most common non-traumatic neurological disorder among young and middle-aged people. The aim of the present study was to examine the cognitive functioning of a group of MS patients. A sample of 80 participants diagnosed with MS and 40 controls received a comprehensive neuropsychological battery. Participants with MS scored lower than controls on all of the neuropsychological tests and significantly lower (p < .05) on 84% (16/19) of them. The global neuropsychological profile of the MS group included deficits in executive function, speed of information processing, memory, visuo-spatial abilities and attention. Cognitive deficits are one of the main symptoms of MS. Recognition of these deficits is relevant both to the diagnosis and rehabilitation of this disorder.     

Working memory – not processing speed – mediates fluid intelligence deficits associated with attention deficit/hyperactivity disorder symptoms

Attention deficit/hyperactivity disorder (ADHD) is a psychological condition characterized by inattention and hyperactivity. Cognitive deficits are commonly observed in ADHD patients, including impaired working memory, processing speed, and fluid intelligence, the three of which are theorized to be closely associated with one another. In this study, we aimed to determine if decreased fluid intelligence was associated with ADHD, and was mediated by deficits in working memory and processing speed. This study tested 142 young adults from the general population on a range of working memory, processing speed, and fluid intelligence tasks, and an ADHD self‐report symptoms questionnaire. Results showed that total and hyperactive ADHD symptoms correlated significantly and negatively with fluid intelligence, but this association was fully mediated by working memory. However, inattentive symptoms were not associated with fluid intelligence. Additionally, processing speed was not associated with ADHD symptoms at all, and was not uniquely predictive of fluid intelligence. The results provide implications for working memory training programs for ADHD patients, and highlight potential differences between the neuropsychological profiles of ADHD subtypes.     

Beery-Buktenica Developmental Test of Visual-Motor Integration performance in children with traumatic brain injury and attention-deficit/hyperactivity disorder

Evaluation of visuoconstructional abilities is a common part of clinical neuropsychological assessment, and the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI; K. E. Beery & N. A. Beery, 2004) is often used for this purpose. However, few studies have examined its psychometric properties when used to assess children and adolescents with traumatic brain injury (TBI) or attention-deficit/hyperactivity disorder (ADHD), even though these are among the most common acquired and neurodevelopmental forms of brain dysfunction in children. This study examined the validity of VMI scores in 123 children with TBI and 65 with ADHD. The TBI and ADHD groups performed significantly worse than the standardization sample, obtaining VMI mean scores of 87.2 (SD = 13.7) and 93.5 (SD = 11.27). Previous research has noted decrements in visuoconstructional abilities in TBI but relative sparing in ADHD. To examine the criterion validity of VMI scores, the authors therefore compared these 2 groups. As anticipated, the TBI group performed significantly worse than the ADHD group, but receiver operator characteristic analysis indicated that VMI scores were poor at discriminating between groups. Nonetheless, convergent validity evidence supported interpretation of VMI scores as measuring perceptual organization in both groups. In particular, principal components analysis indicated that VMI total scores loaded with perceptual organization tests from the Wechsler Intelligence Scale for Children, 3rd ed. (WISC-III; D. Wechsler, 1997), and its highest correlation was with the WISC-III Perceptual Organization Index. Also, the VMI correlated significantly with the Grooved Pegboard test for the group with TBI. These findings suggest that VMI scores are sensitive to visuoconstructional and motor deficits in children with developmental and acquired brain dysfunction.     

THE BRITISH ABILITY SCALES SPEED OF INFORMATION PROCESSING SUBTEST: WHAT DOES IT MEASURE?

Summary . Recent theory and research has focused on the relationship between speed of performing elementary cognitive operations and general intelligence. The developers of the British Ability Scales (BAS) included the Speed of Information Processing (SOIP) subtest as a measure of mental processing speed. To test the validity of the SOIP subtest, a group of 12-year-old children were given the BAS short-form, including the SOIP subtest, and a series of electronically timed reaction time (RT) tasks. Correlations between RT and SOIP were higher than correlations between RT and other BAS subtests, suggesting convergent and discriminant validity. A hierarchical factor analysis of the data shows that the BAS SOIP subtest is related more to speed of apprehension (RT) than to speed of making the motor response, or movement time (MT).     

Perceptual skills of children with developmental coordination disorder

The aim of this study was to investigate whether children with a Developmental Coordination Disorder (DCD) experience problems in the processing of visual, proprioceptive or tactile information. Different aspects of visual perception were tested with the Developmental Test of Visual Perception (DTVP-2), tactile perception was assessed with the Tactual Performance Test (TPT), and a manual pointing task was employed to measure the ability to use visual and proprioceptive information in goal-directed movements. Nineteen children with DCD and nineteen age and sex-matched controls participated in this study. Differences between groups were most pronounced in the subtests measuring visual-motor integration of the DTVP-2, and in two subtests measuring visual perception (visual closure and position in space). On average the children with DCD performed slightly below the norm for tactile perception, with only three children failing the norm. On the manual pointing task, children with DCD made inconsistent responses towards the targets in all three conditions (visual, visual-proprioceptive and proprioceptive condition). No significant differences between groups were found for absolute error. Inspection of the individual data revealed that only two children failed on the majority of perceptual tasks in the three modalities. Across tasks, no consistent pattern of deficits appeared, illustrating the heterogeneity of the problems of children with DCD.     

Cognitive deficits of executive functions and decision‐making in obsessive‐compulsive disorder

The nature of cognitive deficits in obsessive‐compulsive disorder (OCD) is characterized by contradictory findings in terms of specific neuropsychological deficits. Selective impairments have been suggested to involve visuospatial memory, set shifting, decision‐making and response inhibition. The aim of this study was to investigate cognitive deficits in decision‐making and executive functioning in OCD. It was hypothesized that the OCD patients would be less accurate in their responses compared to the healthy controls in rational decision‐making on a version of the Cambridge gambling task (CGT) and on the color‐word interference test and on a version of the Tower of Hanoi test (tower test) of executive functioning. Thirteen participants with OCD were compared to a group of healthy controls (n = 13) matched for age, gender, education and verbal IQ. Results revealed significant differences between the OCD group and the healthy control group on quality of decision‐making on the CGT and for achievement score on the tower test. On these two tasks the OCD group performed worse than the healthy control group. The symptom‐dimension analysis revealed performance differences where safety checking patients were impaired on the tower test compared to contamination patients. Results are discussed in the framework of cognition and emotion processing and findings implicate that OCD models should address, specifically, the interaction between cognition and emotion. Here the emotional disruption hypothesis is forwarded to account for the dysfunctional behaviors in OCD. Further implications regarding methodological and inhibitory factors affecting cognitive information processing are highlighted.     

Neurocognitive Impairment in Early Adolescence Following Prenatal Alcohol Exposure of Varying Duration

The aims of the study were, first, to perform a comprehensive assessment of neurocognitive status in early adolescence of children exposed to alcohol prenatally; and, second, to examine whether duration of exposure continues to be predictive of outcome at this age. Twenty-seven exposed 12-14-year-olds and 39 nonexposed 13-14-year-olds underwent neuropsychological assessments (WISC-III, NEPSY subtests) of attention and executive functions, language, visuomotor functions, and memory. The group of non-exposed children was used to develop preliminary test norms for the 13-14-year-old exposed children whereas published test norms could be used for the 12-year-olds. The results demonstrated neurocognitive impairment across all types of tasks. Impairment varied in degree according to the duration of alcohol exposure. Children exposed throughout pregnancy, most of who had diagnoses of Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Effects (FAE), performed well below the average range. It was concluded that the neurocognitive effects of alcohol exposure tend to be widespread and generalized. Attention and executive functions do not seem to be selectively affected. Further, the relationship between duration of prenatal alcohol exposure and neurocognitive development continues to be significant in early adolescence.     

Neurocognitive impairment in early adolescence following prenatal alcohol exposure of varying duration.

The aims of the study were, first, to perform a comprehensive assessment of neurocognitive status in early adolescence of children exposed to alcohol prenatally; and, second, to examine whether duration of exposure continues to be predictive of outcome at this age. Twenty-seven exposed 12-14-year-olds and 39 non-exposed 13-14-year-olds underwent neuropsychological assessments (WISC-III, NEPSY subtests) of attention and executive functions, language, visuomotor functions, and memory. The group of non-exposed children was used to develop preliminary test norms for the 13-14-year-old exposed children whereas published test norms could be used for the 12-year-olds. The results demonstrated neurocognitive impairment across all types of tasks. Impairment varied in degree according to the duration of alcohol exposure. Children exposed throughout pregnancy, most of who had diagnoses of Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Effects (FAE), performed well below the average range. It was concluded that the neurocognitive effects of alcohol exposure tend to be widespread and generalized. Attention and executive functions do not seem to be selectively affected. Further, the relationship between duration of prenatal alcohol exposure and neurocognitive development continues to be significant in early adolescence.     

The Impact of Neuropsychological Deficits on Functional Stroke Outcomes

This review examines the available literature on neuropsychological outcomes of stroke and the literature on the ability of specific areas of neuropsychological deficit to predict functional stroke outcome. The literature reviewed indicates that post-stroke deficits in executive function, memory, language, and speed of processing are common, with those identified as having progressive ‘post-stroke dementia’ presenting with a similar, though more impaired profile, with increased impairments particularly noted in the area of memory. It is clear that some aspects of neuropsychological functioning (e.g., presence of neglect, aphasia, anosognosia; and verbal memory and attention deficits) show promise as a means of predicting post-stroke functional outcomes. Examining the available literature, it becomes evident that there is a need for long-term, large scale (i.e., population based) follow-up studies, evaluating likely long-term neuropsychological outcomes of stroke and their prognostic utility.