Cognitive Tests: Conceptual and Practical Applications

Chapter 13: Neuropsychological assessment in SA

AUTHOR: M. Lucas

ABSTRACT: Neuropsychology is frequently defined as the relationship between brain functioning and behavior but with the collapse of Cartesian dualism, this focus has been expanded.  With the mind today seen as the output of the brain it is therefore available to objective consideration as well.  Modern Neuropsychology thus encompasses not only the understanding and interpretation of structural/functional brain systems but includes broader understandings such as the subjective experience of self (Solms, 2006). There have been two traditions in Neuropsychology: A syndrome based approach, dependent upon a clinic-anatomical analysis, which we will refer to as the clinical approach; and a cognitive neuroscientific approach, with close links to information processing and artificial intelligence.  The former approach has its origins in the times of cortical localization beginning with Broca, Wernicke and Charcot, but more recently is based upon integrated theories of brain function; while the latter approach is based on principles of cognitive psychology and assumes that mental activities operate in terms of specialized sub-systems or modules.  It has primarily researched cognitive systems that can be separated out (dissociated) from each other.  Both approaches are complementary, use case studies, experimental designs and quantitative analysis.  Each adds valuable information to the study of the brain and mind and currently they are moving towards a more unified model.

Clinical neuropsychology is primarily concerned with anatomical brain variants and pathology and uses the syndrome-based medical model as its theoretical basis.  Typically this discipline is concerned with assessment, diagnosis, management and rehabilitation of people who have neurocognitive impairment.  Deficits are usually acquired as a result of illness and injury to the nervous system; may be temporary or permanent but measurable by subjective complaints (e.g. I am forgetful) and objective measures (e.g. psychometric tests, neuro-imaging studies). Further, clinical neuropsychology is concerned not only with the cognitive impairments but the emotional and behavioural consequences of such illness and injury.  Most importantly, these areas are assessed within the framework of person’s social and cultural background. Thus, neuropsychological assessment must take place through use of triangulation using firstly, personal narratives, collateral information, medical records and investigations such as neuro-imaging and secondly, extensive knowledge on the part of the psychologist of mind/brain issues, neuroanatomy, pathology and physiology, and thirdly, careful administration, scoring and interpretation of appropriate measures of cognitive, emotional and behavioural functioning.  Test measures may be in the form of appropriate standardised or individualised batteries. In South Africa, Neuropsychologists have typically used the standardized norms supplied by test manufacturers for their middle-class, usually white, clients and made judgements on levels of function using standardized scores and statistical analyses (e.g. standard deviations, z scores, t scores, percentile ranks etc.).  However, this group forms a small part of the South African population, making this approach an invalid one for most South Africans.  There have been attempts to standardize various tests for the local population but this has met with only limited success (e.g. Nell, 1999).  The general failure to produce working norms has been for several reasons: i) population heterogeneity in terms of language, education, socio-economic status and cultural stance ii) a dynamic and emerging population, thus tests standardized for a group have limited life as members become better educated iii) changes in level of test sophistication as communities move from pre-modern (rural) to modern (urban) lifestyles. In the face of these challenges, it has been recommended that neuropsychologists use a more hypothesis driven approach first promulgated by Luria (Solms, 2008) as a basis.  Test scores can be then interpreted from a differential score or pattern analytical approach (Zilmer, Spiers & Culbertson, 2008).

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Chapter 12: The Griffiths Scales in South Africa

AUTHOR/S: L. Jacklin, K. Cockcroft

ABSTRACT: The Griffiths scales were developed by Ruth Griffiths O. B. E. The Abilities of Babies was published in 1954 followed by The Abilities of Young Children in 1970.  These scales were used extensively in the United Kingdom and a variety of other countries. Eventually, it became clear that with greater exposure of children to electronic media and early childhood education that there had been acceleration in the development of children. The Griffiths scales had to be updated to keep pace with the changes. This resulted in the publication of the revision of the Birth to 2 years in 1996 and the   Extended Revised Scales for children of between 2 years and eight years in 2006 .This text will describe the history and development of the scales. The Griffiths scales are one of a variety of tests available for assessing the development of young children. What makes them unique is that they can be used to test children from birth up to the developmental age of eight years across all areas of development. They therefore give a complete profile of the development of the child. The strengths and weaknesses of the use of the Griffiths scales as a test and as a research tool in the South African context will be described. The use of the Griffiths scales is controlled by the Association for Research in Infant and Child Development (ARICD) to ensure that the test is administered by suitably trained testers. The training process is described. Assessment and the development of tools is a dynamic process. The future development of the scales is discussed.

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Chapter 11: The APIL and TRAM learning potential instruments in South Africa

AUTHOR/S: T. Taylor

ABSTRACT: This chapter covers three main topics involving the APIL and TRAM learning potential instruments developed by Aprolab, namely, the underlying theory, the nature and contents of the instruments and technical information. Early theory by Vogotsky, Feuerstein and others suggested that learning potential is solely reflected in the zone of proximal development, the degree to which an individual’s performance improves with intervention.  APIL and TRAM instruments are based on a broader theory drawn from cognitive psychology, information processing theory and learning theory. This theory incorporates four main elements – fluid intelligence, information processing efficiency, transfer and learning rate. The first two constructs are static (not direct measures of learning potential, but nevertheless critical to learning). The last two dimensions are dynamic (direct measures of learning). Only learning rate is related to the zone of proximal development concept from which the learning potential construct originally arose. There are actually three Aprolab learning potential instruments: APIL, TRAM-2 and TRAM-1. They cover the educational spectrum from no education to tertiary education. All of them are based on the theory mentioned above and incorporate separate measures of the four constructs listed above. In some cases the constructs are broken down into sub-dimensions. APIL has eight scores, TRAM-2 six and TRAM-1 five. The sub-dimensions are described, the techniques whereby the raw-scores are converted into normed scores on these sub-dimensions explained, and examples of stimulus material provided. The APIL and TRAM instruments have been used since the mid-90’s. Technical information is given on scale inter-correlations, reliabilities, predictive and concurrent validity, and culture-fairness/lack of bias.

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Chapter 10: The Learning Potential Computerised Adaptive Test (LPCAT) in South Africa

AUTHOR/S: M. de Beer

ABSTRACT: In the multicultural and multilingual South African context where differences in socio-economic and educational background and opportunities of individuals further complicate psychological assessment, the measurement of learning potential provides additional information in the cognitive domain that has shown positive results.  This chapter deals with the history of dynamic assessment internationally and locally and provides empirical results on the LPCAT that provide support for utilizing this approach in conjunction with standard tests of cognitive ability and aptitude.  It further elucidates how the use of Item Response Theory (IRT) and Computerised Adaptive Testing (CAT) addresses a number of practical and measurement issues that have been hampering the wide-scale implementation and use of dynamic assessment of learning potential in assessment in education and in industry.

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Chapter 9: Dynamic Assessment in South Africa

AUTHOR/S: Z. Amod & J. Seabi

ABSTRACT: This chapter outlines current developments in Dynamic Assessment (DA), an interactive assessment procedure that uses deliberate and planned mediational teaching and assesses of the impact of that teaching on subsequent performance. The objective of the chapter is to critically review the major criticisms of the traditional “static“ testing approach, discuss the theoretical basis of the DA approach and its relevance within the South African context, present current empirical research on the Dynamic Assessment of children, and suggest some directions for future research. The DA approach has been motivated by the inadequacy of traditional “static” tests to provide accurate information about the individual’s ability. Given that the history of “static” testing in South Africa closely resembles the racial policies of apartheid, which attempted to preserve and perpetuate social structures (Benjamin & Lomosfky, 2002), and that many of such tests have been standardized on middle class children, concerns regarding the relevance of traditional testing have been raised.  DA is presented in this chapter as an alternative approach that minimizes discriminatory approaches to the assessment of culturally different populations and facilitates a strong link between assessment and intervention.  DA is aimed at changing and modifying the individual’s cognitive structures within the assessment process. The theoretical foundations of DA are derived primarily from Vygostky’s socio-cultural theory, specifically the zone of proximal development, and Feuerstein’s Mediated Learning Experience theory. DA has been applied with different educational and clinical groups of children and adolescents both abroad and in South Africa and has been found to be more accurate in reflecting children’s learning potential. Although the DA approach has a great appeal to many professional psychologists and educators, it has not yet become a central part of prevailing practice. Major critiques leveled against the DA approach are discussed.

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Chapter 8: The Cognitive Assessment System (CAS) in a South African context

AUTHOR/S:  Z. Amod

ABSTRACT: Limitations of current intelligence tests, the search for more equitable assessment procedures and the need to link assessment with intervention have led to the exploration of alternative forms of cognitive assessment.  Information processing models of assessment embodied in the work of Luria, Kaufman and Das, for instance, are in the forefront of the latest developments in cognitive psychology.  In this chapter the Cognitive Assessment System (CAS) developed by Das and Naglieri (Das, Naglieri & Kirby, 1994) is discussed both theoretically and in relation to research conducted mainly abroad but also in South Africa. This novel assessment approach is based on the Planning, Attention, Simultaneous and Successive (PASS) model of cognitive functioning. There is empirical support for the PASS theory and the CAS (Naglieri, 1999; Van Luit, Kroesbergen and Naglieri, 2005) and extensive research has been conducted to establish the relationship between certain cognitive processes of the PASS model and specific academic skills (Kirby and Das, 1990; Hold, 2000; Lerew, 2003; Germain, 2004). The usefulness and application of the CAS instrument in South Africa has been indicated by several studies (Chow and Skuy, 1999; Churches, Skuy & Das; Fairon, 2006; Floquet, 2008; Hofmeyer 2000; Naidoo, 2001; Reid, Kok & van der Merwe, 2000). The PASS Remedial Programme (Das et al, 1994) has been developed to provide a link between cognitive processing strategies and academic content. It is proposed in this chapter that the PASS model as operationalized by the CAS is a valuable alternative or at least adjunct to traditional intelligence tests. Further research needs to be conducted which combines the Information Processing model with Dynamic Assessment, to facilitate a link between assessment and intervention.

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Chapter 6: Assessing young children in South Africa

AUTHORS: Z. Amod, D. Heafield

ABSTRACT: This chapter explores the complexities, purpose and relevance of school-readiness assessment within the South African context as well as the existing research in this field.  The concept of school-readiness assessment is a contentious issue in this country. This is firstly due to the historical misuse of assessment instruments for the purpose of exclusionary practices and the perpetuation of an inequitable education system.  Secondly children in this country exist within extremely diverse socio-cultural and economic structures and this contributes towards significant emotional and developmental differences between young children. A linear, maturational model of school-readiness assessment (as espoused by Kagan, 1992, 1994 and Damarest, Reisner, Humphrey & Stein, 1993) therefore seems immensely inadequate, and denying a child the right to begin school at the appropriate age based on this model could be considered both discriminatory and unfair. It is partly for this reason that the government has imposed an informal moratorium on school readiness assessment within government schools. The objective of this chapter is therefore to propose a more holistic and eco-systemic view of school readiness assessment, based on a critique (which includes strengths and limitations) of existing approaches.  The move towards an inclusive education and training system which has been outlined in Education White Paper 6 (2001) places the responsibility on schools, and the education system as a whole, to provide adequate support structures to accommodate a diverse range of children with a variety of barriers to learning. The emphasis on learners being ready for school has therefore shifted to schools being ready for all learners.   This interactional / bi-directional concept of school readiness is supported in the literature (Meisels, 1996) and in a recent South African study (Goldblatt, 2004).  Although there is still a place for the assessment of individual learners to determine the types of support structures that may be needed,  government expenditure on education is more suitably spent on upgrading facilities, reducing class sizes and improving teacher training. This will provide all learners with a better chance of reaching their full potential.

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Chapter 4: South African Individual Scales Revised

AUTHOR/S: K. Cockcroft

ABSTRACT: This chapter will provide a brief introduction to the SSAIS-R. The introduction will summarize the purpose and development of the SSAIS-R including its historical links to other traditional psychometric measures of intelligence. Details will be provided regarding administration, scoring, demographic effects, as well as normative data and the standardized sample for this intelligence test. Psychometric properties such as reliability and validity will be commented upon. There will be some discussion on how the SSAIS-R can be used to provide a profile of weaknesses and strengths that will allow for appropriate intervention decisions to be made. Available studies that have used the SSAIS-R in a range of diagnostic and educational settings will be presented and critically evaluated.

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Chapter 3: WISC-IV test performance in a South African context: A collation of cross-cultural norms

AUTHOR/S: A. Edwards

ABSTRACT: This objective of this paper is to present a brief review of cross-cultural research in respect of the WISC-IV, followed by documentation of cross-cultural normative indications in respect of this test within the South African arena. Combined research data are presented in respect of Grade 7 white English, black Xhosa, white Afrikaans and coloured Afrikaans speaking children tested with the WISC-IV (van der Merwe, 2008; van Tonder 2007). In all studies there was additional stratification within language/ ethnic groups for quality of education, viz. relatively advantaged education within the historically white private and/or former Model C educational institutions, versus relatively disadvantaged education within the formerly designated black and coloured township educational institutions. In robust fashion, this outcome in respect of the WISC-IV serves to confirm the indications from earlier WAIS-III cross-cultural research for Grade 12s and Graduates (Shuttleworth-Edwards et al., 2004), of significant lowering of IQ test performance of around 20 IQ points in association with relatively disadvantaged education.  Whereas language and ethnic variables reveal subtle effects on IQ test performance, quality of education has the most significant effect.

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Chapter 2: WAIS-III test performance in a SA context: Extension of an existing cross-cultural normative database

AUTHOR/S: A. Edwards, Gaylard, S. Radloff

ABSTRACT: The aim of this chapter is to present new research data, preceded by a brief review of the application of the Wechsler Adult Intelligence Scale in South Africa, including the SAWAIS (1969), the HSRC standardization of the WAIS-III (Claassen, Holzhauzen, & Mathe, 2001), and prior cross-cultural normative indications (Shuttleworth-Edwards et al., 2004). The latter study provided preliminary normative data for the WAIS-III on a Southern African population, that was stratified for race and first language (‘Black African’ versus ‘White English’), level of education (‘Grade 12’ versus ‘Graduate’) and quality of education (‘Advantaged Education’ via schooling completed within the historically white private and/or former Model C educational institutions, versus ‘Disadvantaged Education’ via schooling completed within the formerly designated black township Department of Education and Training educational institutions). A limitation of the research was the lack of control for language within the black participants that were drawn from the Eastern Cape, South Africa as well as from Zimbabwe.  In order to rectify the lack of homogeneity of language, all non- Xhosa first language participants were excluded from the black sample and sixteen additional Xhosa first language participants were tested on the WAIS-III.  Data analyses found no significant differences between the original and new groups, except in the comparison between mixed African language Private/Model C graduates and the Xhosa first language Private/Model C graduates, where there was a lowering of WAIS-III subtest, index and IQ scores in the latter group.  This lowering is explained in that the pure Xhosa first language group was less educationally advantaged than the original mixed African first language group.  Overall, these results demonstrate an incremental increase in WAIS-III test performance for sample groups on a continuum of quality of education from least to most advantaged education, with quality of education being a more potent variable than race and first language.  This was true for both verbal and non-verbal subtests.

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