Neuropsychological Assessment Using Virtual Environments: Enhanced Assessment Technology for Improved Ecological Validity

Abstract. Although today’s neuropsychological assessment procedures are widely used, neuropsychologists have been slow to embrace technological advancements. Two essential limitations have resulted from this refusal of techno-logical adaptation: First, current neuropsychological assessment procedures repre-sent a technology that has barely changed since the first scales were developed in the early 1900s. Second, while the historical purpose of clinical neuropsychology was differential diagnosis of brain pathology, technological advances in other clinical neurosciences have changed the neuropsychologist’s role to that of mak-ing ecologically valid predictions about the impact of a given patient’s neurocog-nitive abilities and disabilities on everyday functioning. After a brief discussion of current applications of computer-based neuropsychological assessment, there is a discussion of an increasingly important topic in recent decades—the design of ecologically valid neuropsychological instruments to address real world out-comes. Finally, there is an exploration of virtual reality environments for ecologi-cally valid neuropsychological assessments that make use of current technological advances. It is concluded that a future possible virtual reality-based neuropsy-chological assessment battery will combine the control and rigor of technologi-cally advanced computerized laboratory measures, the psychometric rigor (i.e., veridicality) of traditional paper-and-pencil assessments, and verisimilitude ap-proximating real life situations.