© 2010
  University of Idaho
  All rights reserved.
  Psychology Dept.
  University of Idaho
  Design - P&D  CTI

Now, as we see in slide three, there are generally two approaches to giving psychological tests to individuals, especially with individuals who have traumatic brain injuries or who have strokes or some other things.  The first approach is what we call patient-centered.  A patient centered approach is more flexible.  Essentially what we do is give tests based on the presenting symptom or set of symptoms.  Or we give the tests based on some particular type of referral issue.

The other approach gives the same battery or what we call a fixed battery of tests.  That is, we give the same test to everyone.  Then we add some other tests as we see necessary.

Now there are a variety of different types of tests when you look at neuro-psychological testing, and other psychological testing.  The first of these (as we see in slide five), is what is called the Halstead - Reitan Psychological Test Battery, or what is usually called the Halstead-Reitan.  The Halstead-Reitan contains 10 different sub-sets of tests.  They examine a variety of different types of brain functions as you can see here.  There are a variety of tests that I’ve listed.   For example, kinesetic and sensor motor ability, attention, auditory perception, and many, many others. 

Here are some general tests that we have with the Halstead-Reitan.  These are shown on slide six.  You can try these tests with another individual or friend.  So, one test is to have someone close their eyes with their hands held out.  Then have the person say which hand is being touched when it’s touched by someone.  Or, have somebody draw a shape on the finger, or hand.  Key tapping is kind of the old Morse key that you used to see in the movies.  How many times can you do that in a minute?  There are many, many other types of tests as well.

In general (as we see on slide seven), normal individuals can perform the tests very well. In fact, you’d be surprised at how well people can do these things.  However, individuals that have some kind of neuro-psychological damage have very severe difficulty with these tests.  Based on the anatomy and physiology that we know about the brain and how it works, you can deduce very accurately where the brain damage has occurred.

Now, as we see in slide eight, the Halstead-Reitan is not the only thing that we give when we’re doing the neuro-psychological test battery. Oftentimes we add other types of tests.  For example, we can use the memory task such as the WAIS - III, or the MMPI.  We can use a wide variety of different other tests as well.  It just depends on what you’re trying to test. 

Now the Halstead-Reitan, while very, very popular is not the only neuro-psychological test battery that’s out there.  A second neuro-psychological test battery is shown in slide nine and is called the Luria-Nebraska.  It’s the second most common test that we use in relation to a battery of tests.  It consists of 269 discrete items.  It also has high reliability.  That is, you complete test one time, then you do it again and get a very similar score.  It also has some problems.  It has high rates of false positives.  That is, we believe that the person has some damage but they don’t.  This is especially true within older patients. And we can see here in slide 10, it has a wide variety of different types of scales. It has motor scales, written scales, reading scales, and many, many other as well.

So what are the conclusions, then, in relation to the Luria?  Well some people really like it.  However, other people have some problems with it.  So, the results are kind of mixed about how effective it is and how good it actually is.  However, I will tell you that both test batteries (Halstead-Reitan and the Luria-Nebraska are very, very good at diagnosing problems and can be extremely accurate. 

Now there are many other types of neuro-psychological batteries and tests that we often give to individuals with some kind of different problems.  One of these different types of tests is called the Aphasia screening test.   As you can see here, there are a wide variety of different types.  What these tests examine (as we see in slide 13) are things such as spontaneous speech, reading, writing and copying, and other things.  It just depends on which test that you’re using which will examine which type of Aphasia that you’re examining.

Another test that we often use is shown in slide 14.  It is called the Bender Gestalt and is used to examine complex motor tasks.  The Bender Gestalt basically has nine figures.  Basically you’re shown a figure and you’re asked to copy the figure on a blank piece of paper.  We look at how accurate you are with copying the particular figure that you’re doing.  Some individuals copy very, very closely while others will be extremely far off. 

The next test that we often use but not as often as the other tests is called the Porteus Maze test.  The Porteus Maze is extremely good at assessing what we call executive functioning, that is reasoning, planning and flexibility of thinking.  Basically what we do is we have a series of different mazes and have the person trace a line through different mazes without lifting their pencil and avoiding dead ends.  This test is extremely, extremely sensitive to brain damage in the frontal lobes because it requires a lot of motor coordination.  Just to keep the line inside of the different mazes, plus, you need to determine where you need to go.  So the test is extremely, extremely sensitive.  It’s also good in examining other things, such as impulsivity.  People have also used it in a variety of different measures.  I have even used this as a screening test when examining alcohol consumption levels.

So in conclusion, there are a lot of different tests that we use to examine brain function.  Some of these are extremely sensitive and can be highly accurate in assessing damage.  They can also be used to help targeting brain damage before other techniques are used.  For example you might use these tests before you do something like an MMRI or an FMRI.  However, these tests are not cheap to administer and often cost between one thousand and two thousand dollars for a neuro-psychological test battery.

In addition to that, the tests are to be given and interpreted by trained professionals.  The training to give these tests is very, very time intensive, In fact just learning the Halstead- Reitan will take you about one semester of graduate school and the interpretation requires very, very specific knowledge and skills.  Also a lot of these tests take lots and lots of practice to be interpreted correctly.  Just as a CT scan is interpreted by radiologists; neuro-psychological test batteries are interpreted by trained psychologists and usually these individuals are neuro-psychologists.

So in general, there are a lot of different neuro-psychological tests out there, they’re used for a lot of different things and they can be extremely sensitive in helping to diagnose problems that you might have a great day.

In the next section, we’re going to begin to talk about different aspects of the nervous system, and so until then we hope you’re enjoying the class.