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Haeli Higgins

on 23 April 2014

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Transcript of NEPSY-II

Domains & Broad Abilities Assessed
Normative data collected from 2005-2006 BUT several subtests based off of old norms (1998)
1,200 cases
50 females, 50 males in each group
Ages 3-16
Stratified sample based on 2003 US Census:
Race, region (NE, MW, S, W), parent education
Test Background
Finnish NEPSY published in 1988
Developed by Marit Korkman, Sally Kemp, & Ursula Kirk
Basis for development - Luria's neuropsychological approach
Revolutionary - one of the first neuropsychological tests designed specifically for children
U.S. NEPSY published in 1998
U.S. NEPSY-II published in 2007
New changes include:
Addition and deletion of certain subtests
Deletion of total domain index scores
Addition of the Social Perception domain
To enhance assessment of students who may have ASD
Expansion of floor and ceilings
Increase in age range (3.0 -16.11)
A Developmental NEuroPSYchological Assessment
Tim Ahn, Brittany Contreras, Leslie Chow, & Haeli Higgins
CSP 615
Spring 2014

General Interpretation
not designed to yield diagnoses
on SLD, language disorders, or ADHD
Subtest-level analysis used to
verify problems
in a child's everyday functioning
Each subtest was designed to measure a specific aspect of cognitive functioning, but
multiple factors contribute to performance on a subtest
Consider sensorimotor or global cognitive deficits that can affect student's performance (
mark penalty
Poor performance on one subtest is not enough to identify dysfunction or disability!
Rule of thumb
: Similar findings on
two or more
primary subtest scores must be present
Clinical Utility
subtest scores considered "more clinically sensitive" (no domain scores)
Two levels of interpretation
Psychometric (
functions are impaired)
Clinical analysis (
functions are impaired)

able to choose relevant subtests; norms support this "flexible approach to assessment"
Save time
"More meaningful" scores
Interpretation Hypotheses
Assessment Planner (what are you looking for?)
Types of Assessment
When the results from the general assessment demonstrate a concern in a particular area the authors suggest testing with related subtests as well as other subtests.
Time is dependent on subtests and student
Referral concerns or previous scores indicate presence of a specific problem
In order to investigate the problem in greater depth
Selection of batteries are organized into the following:
Learning Differences -Reading
Learning Differences -Math
Behavior Management
Language Delays/Disorders
Perceptual/Motor Delays/Disorders
School Readiness
Social Interpersonal
Time is dependent on subtest and student
Recommended for all students
Provides overview of child's performance across 5 functional domains
Approximate time frame for general:
Preschool: 45 minutes
School-age: 1 hour
Administration of every subtest depending on age range
Recommmended for a thorough neurodevelopmental evaluation due to brain damage or dysfunction
Cerebral palsy, epilepsy, very low birth weight, chemotherapy
Approximate time frame for full:
Preschool: 90 minutes
School-age: 2.5-3.5 hours
Developmental & Neuropsychological Approach
Basic components:
Subtests that assess basic components of cognition (e.g., fingertip tapping)
Complex cognition
Subtests to assess complex cognition, requiring skills from basic components (e.g., auditory attention)
Scores can help inform how performance in one can influence performance in other, more complex cognitive processes
Performance on
tests would ceiling at early age and
improves over childhood
Behavioral Observations:
Provides quantitative data on common bx's observed in clinical populations
Expressed as percents or cumulative percentages
Primary Scores:
Available for all subtests
Represents global aspects or key clincial variables of each subtest
Describes overall/main abilites involved
Expressed as Scaled Scores
Some are percentile ranks
Process Scores:
More specific primary scores
Allows for a deeper examination of specific abilites that may be influencing performance
Expressed as percentile rank, scaled score, or cumulative %
Affect Recognition
Process score for emotion error type -- may only be relevant to certain assessment questions
Purpose & Use
Designed to test
cognitive functions
not typically covered by general ability or achievement batteries
Investigate both school-based problems and clinical or referral questions in problem areas of
executive functioning
Identify a child’s
strengths and weaknesses
to assist in intervention planning in school
of subtest combo's -- create
tailored assessment batteries
across six domains, specific to the referral questions or diagnostic concerns
Combined Scaled Scores
Special type of primary score
Total subtest scores made by combing 2 measures within subtest- 2 normed scores
1. Speed
2. Accuracy
Understand how child achieved score
Help suggest interventions
Contrast Scale Scores
Way to compare higher level (complex) and lower level (basic) functioning
Expressed as scaled scores
Domain Interpretation
Attention and Executive Domain
Flexibility in administration (saves time)
Assessment Planner
Interpretation Hypotheses
Complicated psychometrics
No composites (if this is what you are looking for)
Norms are old
Extensive preparation
Domain 1:
Attention & Executive Functioning
Domain 2:
Domain 3:
Memory & Learning
Domain 6:
Visuopatial Processing
Domain 5:
Social Perception
Domain 4:
Subtests include:
Animal Sorting, Auditory Attention and Response Set, Clocks, Design Fluency, Inhibition, & Statue
Subcomponents assessed:
inhibition of learned and automatic responses
monitoring and self-regulation
selective and sustained attention
the capacity to establish, maintain, and change a response set
problem solving
planning and organizing a complex response
figural fluency
Subtests include:
Body Part Naming and Identification, Comprehension of Instructions, Oromotor Sequences, Phonological Processing, Repetition of Nonsense Words, Speeded Naming, and Word Generation
Subcomponents assessed:
phonological processing
the ability to repeat nonsense words
comprehension of oral instructions
name or identify body parts
quickly name stimuli on a page
display verbal semantic fluency
produce rhythmic oral sequences
Subtests include:
List Memory, Memory for Designs, Memory for Faces, Memory for Names, Narrative Memory, Sentence Repetition, Word List Interference
Subcomponents assessed:
immediate memory for sentences
narrative memory under free recall
cued recall and recognition conditions
repetition and recall of words presented with interference
immediate and delayed memory for abstract designs, faces, names, and lists.
Subtests include:
Arrows, Block Construction, Design Copying, Geometric Puzzles, Picture Puzzles, and Route Finding
Subcomponents assessed:
the ability to judge line orientation
copy two-dimensional geometric figures
reconstruct three-dimensional designs from a model or picture
mentally rotate objects
deconstruct a picture into its constituent parts
recognize part-whole relationships
use a small schematic map to locate a target on a larger schematic map
Subtests include:
Affect Recognition and Theory of Mind
Subcomponents assessed:
facial affect recognition
the ability to comprehend others perspectives, intentions, and beliefs (i.e., theory of mind)
Subtests include:
Fingertip Tapping, Imitating Hand Positions, Manual Motor Sequences, and Visuomotor Precision
Subcomponents assessed:
the ability to imitate hand positions
produce repetitive and sequential finger movements and rhythmic sequential hand movements
use a pencil with speed and precision
Corresponding CHC Factors:

Crystallized Intelligence (Gc)
General (Domain-Specific Knowledge (Gkn)
Processing Speed (Gs)
Corresponding CHC Factors:

Psychomotor Abilities (Gp)
Short-Term Memory (Gsm)
Processing Speed (Gs)
Corresponding CHC Factors:

Fluid Reasoning (Gf)
Short-Term Memory (Gsm)
Processing Speed (Gs)
Crystallized Knoweldge (Gc)
Visual Processing (Gv)
Psychomotor Abilities (Gp)
Corresponding CHC Factors:

Fluid Reasoning (Gf)
Short-Term Memory (Gsm)
Processing Speed (Gs)
Crystallized Knoweldge (Gc)
Psychomotor Abilities (Gp)
Psychomotor Speed (Gps)
Auditory Processing (Ga)
Long-Term Retrieval (Gltr)
Internal Consistency:

Split-half, alpha, test-retest, decision consistency
Most .7 or higher; several in high .6 range
Lowest when using test-retest method (no parallel forms)

Manual claims "relatively strong stability"
Correlation: Lowest is .18 for 7-8:year olds on IH Total Score (most .6 and above)
Decision Consistency ("less stringent"): range from .46 (9-10:11 year olds for Manual Motor Sequences) to .99 (Finger Tapping Sequences Combined Score)
*Practice effects largest for Memory and Learning Domain (obviously)

high, ranging from .98-.99 for objective scoring; 93-99% for subtests with more "interpretive" scoring (e.g., Design Copying)
Corresponding CHC Factors:

Short-Term Memory (Gsm)
Long-Term Retrieval (Gltr)
Visual Processing (Gv)
Crystallized Knoweldge (Gc)
Corresponding CHC Factors:

Visual Processing (Gv)
Basic Information
The NEPSY-II does not utilize index/composite or full scale scores
Subtest scores are used to examine a student's strengths and weaknesses

General Scoring Info
Low scores on subtests
Poor initiation or self-monitoring ability
Poor selective or sustained attention
Low cognitive flexibility
Ability to adopt, maintain, and change set
Poor working memory
Slow response speed
Poor planning and organization
Poor inhibitory control
Ability to control impulsive responding
Poor conceptual reasoning or semantic knowledge
Poor clock reading or drawing ability (Clocks)
To consider
: If the student has low scores in this domain, is it because of
simple attention
problems or more complex
Language Domain
Low scores on subtests
Underdeveloped semantic knowledge
Poor language analysis
Poor phonological awareness and processing
Reduced ability to follow multi-step commands (Comprehension of Instructions)
Slow processing speed (Speeded Naming)
Poor initiation and executive control (Word Generation)
Speech production motor-related deficits
Poor articulation
To consider
: Are the student's difficulties related to
Which subprocess(es) affects the student's linguistic abilities?
Oromotor control
Phonological processing
Memory & Learning Domain
Low scores on subtests
Poor rote memory or supra-span learning skills for verbal material (
List Memory & Delayed
Poor visuospatial memory (
Memory for Designs
Poor ability to discriminate among faces (
Memory for Faces
Poor learning or retrieval of verbal labels (
Memory for Names
Poor verbal expression of comprehension (
Narrative Memory
Poor verbal short-term memory (
Sentence Repetition
Poor verbal working memory (
Word List Interference

Sensorimotor Domain
Low scores on subtests
Poor fine-motor control or coordination
Poor visuospatial processing
Poor coordination and organization of rhythmic, sequential movements (Manual Motor Sequences)
Executive function issues (Visuomotor Precision)
Inhibition of impulsive responses
Planning ahead
Estimating difficulty of track
Monitoring of ongoing drawing

Social Perception Domain
Low scores on subtests
Poor facial affect recognition (Affect Recognition)
6 total affects
Problems related to perspective taking (Theory of Mind)
Poor ability to match appropriate affects to contextual clues (Theory of Mind)

Visuospatial Domain
Low scores on subtests
Poor ability to integrate visual and spatial skills
Poor planning ability
Deficits in gestalt perception (Block Construction)
3D figures
Poor mental rotation skills (Geometric Puzzles)
Poor scanning ability (Picture Puzzles)

To consider
Some children can
for visuospatial problems with better
, memory, and
attention/executive functioning abilities
Persistent visuospatial deficits can have a significant impact on many areas, especially
geographical knowledge
math (geometry)
Administration Manual
Clinical and Interpretative Manual
Stimulus Book 1
Stimulus Book 2
Record Forms (Ages 3-4)
Record Forms (Ages 5-16)
Response Booklets (Ages 3-4)
Response Booklets (Ages 5-16)
Animal Sorting Cards (8)
Memory for Design Cards (22)
Memory Grid
Training CD with Audio Files
Red blocks
Scoring Template
User Qualifications
Graduate-level training
Experience in administration and interpretation of standardized clinical instruments
When used for neuropsychological assessment the examiner should have appropriate training in neuropsychology and neuropsychological assessment
Before Administration
Evaluate Three Areas of the child's development:

1. Medical, Social, Educational History, and current level of performance
2. Genetic Risk Factors
3. Home and School Environment

To create a "complete picture" of the child's functioning than would be available from a single source.
During Assessment
The authors describe in the manual how important it is to observe the student's behavior and responses during the test and during breaks.
Administration Time
Time varies by type of assessment
Administration manual gives time estimates for each subtest by age group and special group (ADHD, AUT, DHH)
Subtest Demonstration
Overall Interpretation
Two methods of interpretation
1. Psychometric comparison
Normative analysis
Ipsative analysis
Connect to observations and information relevant to student's everyday functioning
2. Clinical Analysis
Used to determine why a student's functions are impaired
Using pattern of student's scores, you can gain more information about what kind of disorder/deficit a student may have
Student must also have medical, genetic, or environmental factors that are indicative of the disorder (ecological)
Content Validity:
Cited use of literature reviews, expert consultations and empirical evaluations
Examination of responses during development – possibility of previously excluded answers
Construct Validity:
Overall six domains show low correlations between subtests (as forewarned by manual)
Concurrent Validity:
Statue (Attn & EF Domain): overall low or no correlations given
Comprehension of Instructions (Language Domain): WISC Subtests (.13-.62; highest with Vocabulary); WIAT (highest with Written Language (.58), Math (.48), Oral Language (.47)); D-KEFS (moderate correlation with Word Interference Scores and Verbalizing Scores)
Arrows (Visuospatial Processing Domain): WISC-IV (.04-.49; highest with Block Design); WIAT (-.01-.21; called “moderate,” justifying “perceptual skills have a role in academic achievement”)

Attention and Executive Functioning
Memory and Learning
Social Perception
Visuospatial Processing
Full transcript