Utility of the CVLT-II Short Form: Differentiating between subgroups of stroke

Objective. The Short Form of the California Verbal Learning Test - Second Edition (CVLT-II SF) is used to screen ability to learn and recall verbal information. The objective of the current study is to examine psychometric properties of the CVLT-II SF in an inpatient stroke rehabilitation sample, with a focus on this tool\u27s ability to differentiate between performances of three groups of individuals with stroke. Participants and methods. Archival data from 75 admissions for inpatient stroke rehabilitation are included in the study. Cronbach\u27s alpha and the Spearman-Brown split-half method are used to examine internal consistency of the learning trials, and a Kuder-Richardson technique is used to analyze the internal consistency of items from the recognition trial. Validity is examined by analyzing correlations between selected CVLT-II SF variables with convergent measures (i.e., tests of attention and memory for verbal information) and discriminant measures (i.e., tests of visuospatial discrimination, verbal abstraction, and cognitive set-shifting). A discriminant function analysis, using seven CVLT-II SF variables, is used to predict membership in three stroke groups: (1) left cortical, (2) right cortical, and (3) subcortical. Predictors include measures of attention span, general verbal learning, delayed recall, recency effect, semantic clustering, recognition discriminability, and recall/recognition contrast. Results and conclusions. Internal consistency of the learning trials and items from the recognition trial are judged to be adequate. Validity, based on correlations between the CVLT-II SF and other neuropsychological tests, suggests that the CVLT-II SF assesses attention and memory for verbal information, though may not be a pure measure of these cognitive domains. The discriminant function analysis significantly differentiates the stroke groups, with a classification procedure correctly classifying over 70% of cases. Individuals with left cortical stroke are well-differentiated from individuals with right cortical stroke and subcortical stroke on the CVLT-II SF, with the left cortical stroke group performing poorer than the other two groups. Measures of attention (Trial 1) and immediate recall (Total of Trials 1 to 4) best differentiate the groups, whereas measures theoretically associated with retrieval of encoded information (i.e., semantic clustering and recall/recognition contrast) do not appear meaningfully related to the discriminant function.Dept. of Psychology. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis2005 .T365. Source: Dissertation Abstracts International, Volume: 66-11, Section: B, page: 6297. Thesis (Ph.D.)--University of Windsor (Canada), 2005

Perception of Control and Awareness of Deficit in Individuals with Neurological Impairment in a Clinical Sample

Acquired brain injury is considered to be one of the most important public health concerns in the United States, with approximately 1.2 million adults that meet the criteria for chronic brain disease, brain disorder, or injury each year. Medical costs directly related to injury, in addition to the indirect costs related to job loss, totaled an estimated 60 billion dollars in the year 2000. Subsequent impairment following brain injury yields a complicated neurobehavioral sequelae of deficits. Anosognosia, specifically, the deficit of the patient\u27s inability to acknowledge, or even recognize impairments, is common following brain injury. In a review of the literature, this study examined the phenomenon of anosognosia, and its relationship to an individual\u27s perception of control. Both the Perception of Control Across Domains Scale (PCADS) and the Neurological Impairment Scale (NIS) were utilized as a measure of self-report, and compared with the patient\u27s test scores on standardized neuropsychological measures. Findings concluded that patients do not reliably report their symptoms. Although the study\u27s findings revealed no significant correlations, implications for the field of psychology are still useful. The rising costs of healthcare have contributed to the problem of insurance companies attempting to eliminate the coverage for neuropsychological testing, in favor of conducting a clinical interview. These findings suggest that clinicians cannot rely solely on patient report to determine an accurate diagnosis

Traumatic experiences and cognition: How do static and dynamic variables contribute to current functioning?

Approximately 25% of children in the United States will witness or experience a traumatic event before age 4, and individuals with a history of trauma, particularly traumatic events in childhood, have a much higher likelihood of developing psychopathology in adulthood. Prior research indicates that the vast majority of individuals with a serious mental illness, particularly those in community mental health centers and psychiatric inpatient settings, have experienced at least one traumatic event in their lifetime. These individuals require special consideration in treatment planning, and a large range of neurodevelopmental and environmental factors must be taken into account when interpreting results of neuropsychological assessment. The current study examines the impact of both “dynamic” factors such as age and diagnosis as well as “static” factors such as trauma history and IQ on performance on two executive functioning measures in a psychiatric inpatient population. Results suggest that while performance is impacted by IQ for executive functioning assessments as a whole, factors such as a history of trauma, the type of traumatic events experienced, psychosis, and the presence of secondary gain may differentially impact performance depending on the specific cognitive functioning abilities being assessed (e.g., basic versus executive)

Validation of brief cognitive tests in mild cognitive impairment, Alzheimer's disease and dementia with Lewy bodies.

Background It is estimated that 34 million people suffer from dementia, costing society US$422 billion each year. Alzheimer’s disease (AD) is the most common dementia and the global prevalence is predicted to increase to over 100 million people by the year 2050, with the greatest increase in developing countries. Therefore, inexpensive and efficient instruments are required for investigation and evaluation. Aim To evaluate the brief cognitive tests cube copying, clock drawing, the Mini-Mental State Examination (MMSE) and A Quick Test of Cognitive Speed (AQT) in the early diagnosis, treatment evaluation and differential diagnosis of dementias. Populations I. 85 patients with AD. II. 33 patients with dementia with Lewy bodies (DLB) and 66 with AD. III. 75 patients with AD. IV. 99 patients with mild cognitive impairment (MCI). Findings I. Cube copying was found useful for evaluating treatment with acetylcholinesterase inhibitors (AChEI) in patients with AD. II. Easy and quick interpretations of the MMSE, clock drawing and cube copying differentiated patients with DLB from patients with AD. III. AQT was twice as sensitive as the MMSE in detecting treatment response to AChEI in patients with AD. IV. The MMSE, AQT and clock drawing were as accurate as cerebrospinal fluid biomarkers (tau, Aβ42 and P-tau) in predicting development of AD and dementia in mild cognitive impairment during an average of five years. Conclusion This thesis has improved the validity of brief cognitive tests and contributed with results that can be clinically relevant for evaluating treatment of AD, differentiating DLB from AD, and predicting development of AD and other dementias

A qualitative analysis of figural memory performance in persons with epilepsy

This study examined nonverbal memory in patients with intractable temporal lobe epilepsy (TLE) on a figural reproduction task, the Rey-Osterrieth Complex Figure (ROCF). The Boston Qualitative Scoring System (BQSS) was used to examine whether qualitative features of ROCF performance could discriminate between those with right and left TLE. As predicted, seizure groups did not differ on a standard quantitative scoring system for the ROCF. Contrary to prediction, the right TLE group did not perform more poorly on BQSS measures of quality or organization, and they did not have greater difficulty recalling the figure after a delay. There was a trend towards poorer performance by the right TLE group on 2 BQSS scales, those quantifying the presence or absence of elements of the figure. ROCF performance was more strongly correlated with measures of visuoperception than with additional measures of nonverbal memory. Thus, the BQSS does not appear to be assessing nonverbal memory, and the implications of the ROCF as a visuoperceptual task are discussed

Dressing after stroke

The literature available indicates that dressing difficulties after stroke are common and persistent. Previous studies have documented dressing ability but none have investigated each individual component of the dressing process using a detailed dressing assessment suitable for stroke patients. The aims of this study were: to develop a dressing assessment (Nottingham Stroke Dressing Assessment) breaking dressing down into its component parts; to identify dressing problems; and to investigate the relationship between dressing ability and physical, perceptual and cognitive disabilities due to stroke. A series of 60 male and female stroke patients were assessed on their dressing abilities using the Nottingham Stroke Dressing Assessment on four occasions over their first 14 days after admission to the Nottingham Stroke Unit. During this time patients were also assessed on the Rivermead ADL scale, Rivermead Motor Function and other physical, perceptual and cognitive assessments. The frequency of problems in dressing were determined. The most difficult problems were pulling up trousers, putting shoe on affected foot and pulling up pants. The relation between dressing score and all other assessments was determined using a Spearman's Rank Correlation Coefficient. There were statistically significant correlations between dressing and activities of daily living, gross motor function, leg and arm function, perception, sensation, language, hand-eye coordination and intelligence. No significant relation was found with apraxia, memory, premorbid IQ or reasoning ability. These results suggest that motor recovery and perceptual abilities are important determinants of dressing ability as has been suggested by previous studies. NB: This ethesis has been created by scanning the typescript original and contains some inaccuracies. In case of difficulty, please refer to the original text

Mobile Dyslexic Specialized Digital Game-based Learning Object for Learning Letters (DOLL)

Ability to read is a unanimous privilege we have as human. Therefore, research and development on Learning Object (LO) specially built for learning disabilities children is crucial. The issues for this project are the problem encounter by dyslexic students in output generation and information processes; and the factors that affect the effectiveness of mobile learning specially built for dyslexic. The focuses of this project are to propose guidelines and to facilitate student with visual dyslexia, or/and auditory dyslexia or/and dysgraphia; specifically in learning basic Malay language letters with interactive teaching method. Research has been made to identify the focused type of dyslexia, determine the needs of dyslexic; and the effect of graphic and animation on the efficiency of teaching technique. New multimedia-based learning object is being proposed to attract interest of dyslexic children to learn letters in fun approach and improve their recalling skills in recognizing name, shape and sound of letters. The main elements of the proposed learning object are animation, oral narration and digital gamebased. The theoretical framework proposed in this study is based on Principles of Teaching Program for Dyslexics, Stansfield Instructional Strategies, and Game-based Learning Object Framework. This project is carried out using ADDIE Instructional Design Model using Adobe Flash Professional cs5.5. A user experience testing is conducted with the dyslexic children. The result of the user experience testing showed more than half of the students would like to use the LO repeatedly. In addition, teachers agreed that DOLL act as a good new teaching tool in facilitating teaching process for dyslexic students

Dressing after stroke

The literature available indicates that dressing difficulties after stroke are common and persistent. Previous studies have documented dressing ability but none have investigated each individual component of the dressing process using a detailed dressing assessment suitable for stroke patients. The aims of this study were: to develop a dressing assessment (Nottingham Stroke Dressing Assessment) breaking dressing down into its component parts; to identify dressing problems; and to investigate the relationship between dressing ability and physical, perceptual and cognitive disabilities due to stroke. A series of 60 male and female stroke patients were assessed on their dressing abilities using the Nottingham Stroke Dressing Assessment on four occasions over their first 14 days after admission to the Nottingham Stroke Unit. During this time patients were also assessed on the Rivermead ADL scale, Rivermead Motor Function and other physical, perceptual and cognitive assessments. The frequency of problems in dressing were determined. The most difficult problems were pulling up trousers, putting shoe on affected foot and pulling up pants. The relation between dressing score and all other assessments was determined using a Spearman's Rank Correlation Coefficient. There were statistically significant correlations between dressing and activities of daily living, gross motor function, leg and arm function, perception, sensation, language, hand-eye coordination and intelligence. No significant relation was found with apraxia, memory, premorbid IQ or reasoning ability. These results suggest that motor recovery and perceptual abilities are important determinants of dressing ability as has been suggested by previous studies. NB: This ethesis has been created by scanning the typescript original and contains some inaccuracies. In case of difficulty, please refer to the original text