Kaplan + Sadock's Synopsis of Psychiatry, 11e

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5.6 Neuropsychological and Cognitive Assessment of Children

Table 5.6-1 Cognitive Tests

Test

Age Range

Description

Intellectual tests Omnibus intellectual and ability tests Wechsler Preschool and Primary Scale of Intelligence–3 rd edition (WPPSI-III) Wechsler Intelligence Scale for Children–4 th edition (WISC-IV) Wechsler Adult Intelligence Scale–4 th edition (WAIS-III) Stanford-Binet Intelligence Scales–5 th edition (SB5) Kaufman Assessment Battery for Children–2 nd edition (KABC-II)

2.6 yrs–7.3 yrs

The tests consist of several subtests that can be combined in different ways to understand basic intellectual functioning. The Wechsler tests yield a full-scale intelligence quotient (IQ) score, as well as over- all scores within the verbal and nonverbal areas. There are ways of grouping subtests of the WISC and WAIS to distinguish between more pure verbal and perceptual reasoning, as well as to measure working memory and processing speed. Because of its age range, the WISC (now with an integrated supplement to evaluate more processing issues related to instructional recommendations) is probably the most familiar of the Wechsler tests to child clinicians. The SB also provides full-scale as well as verbal and nonverbal IQ scores. In addition, it provides factor indexes in fluid reasoning, knowledge, quantitative reasoning, visual–spatial processing, and working memory. The KABC scales and their subtests (which minimize verbal instructions and responses) include measures of sequential and simultaneous process- ing, fluid reasoning and crystallized ability, and long-term retrieval. Many, if not most, cognitive tests (including intellectual, achievement, and processing) are structured in the same way (mean is 100, standard deviation is 15), so results can be compared across instruments. This is particularly important in identifying learning problems. The Gesell is an old test that is still administered by medical profession- als, as well as psychologists. Along with the BSID, the Gesell is as useful for its opportunities for observations as it is for its scores. Both can be helpful in the identification of children at risk for developmen- tal delay. The MSEL, with its five scales (Gross Motor, Visual Recep- tion, Fine Motor, Expressive and Receptive Language), is often valued in assessing readiness for school, as well as in identifying specific interventions for children with developmental disabilities. The MSCA consists of six scales (Verbal, Perceptual–Performance, Quantitative, General Cognitive, Memory, and Motor). It is a good instrument for assessing general strengths and weaknesses in young children. Although the nonverbal tests are often seen as language or culture free, strictly speaking, this is not always true because of representational content or language demands. However, some nonverbal tests (such as the TONI-3) depend more on abstract pattern recognition and can make fewer demands on language systems. The WNV provides batter- ies for younger (4 to 7:11) and older clients (8 to 21:11) and claims to be a general ability measure using nonverbal tests. Tests like Raven’s Progressive Matrices (which actually come in several forms) are based on pattern recognition and thought of as “culturally reduced,” if not unbiased or unloaded. Nonverbal tests can be useful in assessing indi- viduals whose experience falls outside the cultural norm. Although the KBIT and WASI include verbal and nonverbal scores, they do not include as much information as more comprehensive intellec- tual tests. However, they provide an estimate of intellectual level in a fraction of the time. The WRAT has traditionally been seen as a screening instrument. The WRAT4 includes subtests on sentence comprehension, word read- ing, spelling, and math calculation. An expanded version (WRAT-E) provides achievement and intellectual information (nonverbal reason- ing). The PIAT assesses general information, reading recognition and comprehension, written expression, spelling, and mathematics. The KTEA assesses reading (decoding and comprehension), mathematics (applications and calculations), spelling, written expression, and oral language (listening comprehension and oral expression). The WIAT and WJ-ACH also systematically address the basic areas that have been identified as relevant for learning disability. ( continued )

6 yrs–16.11 yrs

16 yrs–90.11 yrs

2 yrs–89 yrs

3 yrs–18 yrs

Infant and child tests Revised Gesell Development Schedules Bayley Scales of Infant Development– 3 rd edition (BSID-III) Mullen Scales of Early Learning (MSEL) McCarthy Scales of Children’s Abilities (MSCA)

1–36 mos 1–42 mos

0–68 mos 2.6 yrs–8.6 yrs

Nonverbal and language-free tests Leiter International Performance Scale– Revised (Leiter-R) Test of Nonverbal Intelligence–3 rd edition (TONI-3) Comprehensive Test of Nonverbal Intelligence (CTONI) Wechsler Nonverbal Scale of Ability (WNV) Raven’s Progressive Matrices Quick tests Kaufman Brief Intelligence Test–2 nd edition (KBIT-2) Wechsler Abbreviated Scale of Intelligence (WASI) Achievement tests Wechsler Individual Achievement Test–3 rd edition (WIAT-II) Woodcock-Johnson–III Test of Achievement (WJ III ACH) Kaufman Test of Educational Achievement–2 nd edition (KTEA-II) Peabody Individual Achievement Test– Revised (PIAT-R) Wide Range Achievement Test–4 th edition (WRAT4) and WRAT– Expanded (WRAT-E)

2 yrs–20.11 yrs

6 yrs–89.11 yrs

6 yrs–89.11 yrs

4 yrs–21.11 yrs

5 yrs–17 + yrs

4 yrs–90 yrs

6 yrs–89 yrs

4 yrs–85 yrs

2 yrs–90 + yrs

4.5 yrs–25 yrs

5 yrs–22.11 yrs

5 yrs–94 yrs 4–24 yrs (Indiv.)