Modified Administration of the WAIS-IV for Visually Impaired Examiners: A Validity Study

Opportunities in all areas of life including education, vocation, and access to general information have historically been slower for minorities. The visually impaired have continued to struggle with access to education, equal opportunities at work, and access to general information. Significantly fewer blind and visually impaired individuals pursue graduate education with the most commonly pursued graduate degree being psychology (American Federation for the Blind, 2010). A core area of graduate training [defined by the American Psychological Association (APA)] is declarative knowledge, which is not accessible for the visually impaired student for neurological assessments (Johnson-Greene, Braden, Dial, Fitzpatrick, Leung, Schneider, & Willis, 2007). The same 27 participants (all with at least 19 years of education) were given both the standardized and the modified WAIS-IV. Participants scored significantly lower on the full scale IQ, the verbal comprehension index, and the processing speed index of the modified version. Validity of the modified WAIS-IV was assessed by comparing the correlation between it and the WIAT-II and the correlation between the standardized WAIS-IV and the WIATII. Despite the significant differences between the modified and standardized WAIS-IV, the standardized WAIS-IV and the WIAT-II, suggesting the modified WAIS-IV is a valid intellectual assessment instrument. The differences between the modified WAIS-IV and the standardized WAIS-IV can be accounted for by three predominate factors: the modifications of the block design and symbol search subtests, the multiple examiners that both administered and scored the WAIS-IV, and potential practice effects resulting from the high level of education of the participants. These findings suggest that the modified WAIS-IV should be further explored as a viable assessment option for visually impaired examiners due to the similarities found between the standardized and modified versions. These findings also highlight exciting potential opportunities for the field as a whole and more specifically for the visually impaired psychology doctoral student and professional psychologist

Emotional Response to Auditory and Visual Stimuli

Emotion can be studied by measuring physiological, behavioral, and verbal responses to specific stimuli. In current research, it is most common to use visual stimuli to measure the emotional response. One of the most common sets of stimuli used for this purpose is the International Affective Picture Systems (IAPS). An additional set of stimuli, the International Affective Digital Sounds (IADS), was created to be an auditory equivalent of the IAPS. The present study sought to compare the emotional response (measured with Heart Rate, Skin Conductance, and a self-report measure of emotion called the SAM) to sounds from the IADS and images from the IAPS. The self-report measure has participants rate each stimulus for arousal, valence, dominance, and interestingness by using a nine point scale anchored at one end by calm, unpleasant, not in control, and boring and at the other by excited, pleasant, in full control, and riveting, respectively. The present study also looked at differences in emotional response to sounds and images when they were presented in a pure block (all images and then all sounds or reverse) compared to a mixed block (a block of sounds and images, followed by a block of sounds and images). There were a total of 40 participants (34 female, 4 male; mean age 27.08), all of whom were recruited from a local university. Results revealed a significant difference (p \u3c .05) in the heart rate and skin conductance response to sounds versus images. There was also a significant (p \u3c .05) difference in self-reported arousal and dominance to images and sounds. Furthermore, there was a significant difference (p \u3c .05) between the Pure Stimulus and Mixed Stimulus groups for heart rate and self-reported arousal and dominance. Results from this study do not support the theory that auditory and visual stimuli evoke similar physiological and self-reported emotional responses. Results also suggest that stimulus presentation may play a role in the observed or perceived difference in emotional response

Determining minimal clinically important differences in the North Star Ambulatory Assessment (NSAA) for patients with Duchenne muscular dystrophy

The North Star ambulatory assessment (NSAA) is a functional motor outcome measure in Duchenne muscular dystrophy (DMD), widely used in clinical trials and natural history studies, as well as in clinical practice. However, little has been reported on the minimal clinically important difference (MCID) of the NSAA. The lack of established MCID estimates for NSAA presents challenges in interpreting the significance of the results of this outcome measure in clinical trials, natural history studies and clinical practice. Combining statistical approaches and patient perspectives, this study estimated MCID for NSAA using distribution-based estimates of 1/3 standard deviation (SD) and standard error of measurement (SEM), an anchor-based approach, with six-minute walk distance (6MWD) as the anchor, and evaluation of patient and parent perception using participant-tailored questionnaires. The MCID for NSAA in boys with DMD aged 7 to 10 years based on 1/3 SD ranged from 2.3-2.9 points, and that on SEM ranged from 2.9-3.5 points. Anchored on the 6MWD, the MCID for NSAA was estimated as 3.5 points. When the impact on functional abilities was considered using participant response questionnaires, patients and parent perceived a complete loss of function in a single item or deterioration of function in one to two items of the assessment as an important change. Our study examines MCID estimates for total NSAA scores using multiple approaches, including the impact of patient and parent perspective on within scale changes in items based on complete loss of function and deterioration of function, and provides new insight on evaluation of differences in these widely used outcome measure in DMD

Children and young people’s versus parents’ responses in an English national inpatient survey

Objective: Despite growing interest in children and young people’s (CYP) perspectives on healthcare, they continue to be excluded from many patient experience surveys. This study investigated the feasibility of, and additional information gained by, measuring CYP experiences of a recent hospital admission. Design: Cross-sectional analysis of national survey data. Setting: Inpatients aged 8–15 years in eligible National Health Service hospitals, July–September 2014. Participants: 6204 parents/carers completed the parent section of the survey. The CYP section of the survey was completed by CYP themselves (n=3592), parents (n=849) or jointly (n=1763). Main outcome measures Pain relief, involvement, quality of staff communication, perceived safety, ward environment, overall experience. Analyses Single-measures intraclass correlations (ICCs) were used to assess the concordance between CYP and parent responses about the same inpatient episode. Multilevel logistic regression models, adjusted for individual characteristics, were used to compare the odds of positive responses when the CYP section of the survey was completed by parents, by CYP themselves or jointly. Results: The CYP section of the survey was completed independently by 57.8% of CYP. Agreement between CYP and parent responses was reasonably good for pain relief (ICC=0.61 (95% CI 0.58 to 0.63)) and overall experience (ICC=0.70 (95% CI 0.68 to 0.72)), but much lower for questions comparing professionals’ communication with CYP and with their parents (ICC range=0.28 (95% CI 0.24 to 0.32) to 0.51 (95% CI 0.47 to 0.54)). In the regression models, CYP were significantly less likely than parents to report feeling safe (adjusted OR (AOR)=0.54 (95% CI 0.38 to 0.76)), involvement in decisions (AOR=0.66 (95% CI 0.46 to 0.94)) or adequate privacy (AOR=0.68 (95% CI 0.52 to 0.89)). Conclusions: Including CYP (8–15 years) in patient experience surveys is feasible and enhances what is known from parents’ responses

Determining minimal clinically important differences in the North Star Ambulatory Assessment (NSAA) for patients with Duchenne muscular dystrophy

The North Star ambulatory assessment (NSAA) is a functional motor outcome measure in Duchenne muscular dystrophy (DMD), widely used in clinical trials and natural history studies, as well as in clinical practice. However, little has been reported on the minimal clinically important difference (MCID) of the NSAA. The lack of established MCID estimates for NSAA presents challenges in interpreting the significance of the results of this outcome measure in clinical trials, natural history studies and clinical practice. Combining statistical approaches and patient perspectives, this study estimated MCID for NSAA using distribution-based estimates of 1/3 standard deviation (SD) and standard error of measurement (SEM), an anchor-based approach, with six-minute walk distance (6MWD) as the anchor, and evaluation of patient and parent perception using participant-tailored questionnaires. The MCID for NSAA in boys with DMD aged 7 to 10 years based on 1/3 SD ranged from 2.3–2.9 points, and that on SEM ranged from 2.9–3.5 points. Anchored on the 6MWD, the MCID for NSAA was estimated as 3.5 points. When the impact on functional abilities was considered using participant response questionnaires, patients and parent perceived a complete loss of function in a single item or deterioration of function in one to two items of the assessment as an important change. Our study examines MCID estimates for total NSAA scores using multiple approaches, including the impact of patient and parent perspective on within scale changes in items based on complete loss of function and deterioration of function, and provides new insight on evaluation of differences in these widely used outcome measure in DMD

Determining minimal clinically important differences in the North Star Ambulatory Assessment (NSAA) for patients with Duchenne muscular dystrophy.

The North Star ambulatory assessment (NSAA) is a functional motor outcome measure in Duchenne muscular dystrophy (DMD), widely used in clinical trials and natural history studies, as well as in clinical practice. However, little has been reported on the minimal clinically important difference (MCID) of the NSAA. The lack of established MCID estimates for NSAA presents challenges in interpreting the significance of the results of this outcome measure in clinical trials, natural history studies and clinical practice. Combining statistical approaches and patient perspectives, this study estimated MCID for NSAA using distribution-based estimates of 1/3 standard deviation (SD) and standard error of measurement (SEM), an anchor-based approach, with six-minute walk distance (6MWD) as the anchor, and evaluation of patient and parent perception using participant-tailored questionnaires. The MCID for NSAA in boys with DMD aged 7 to 10 years based on 1/3 SD ranged from 2.3-2.9 points, and that on SEM ranged from 2.9-3.5 points. Anchored on the 6MWD, the MCID for NSAA was estimated as 3.5 points. When the impact on functional abilities was considered using participant response questionnaires, patients and parent perceived a complete loss of function in a single item or deterioration of function in one to two items of the assessment as an important change. Our study examines MCID estimates for total NSAA scores using multiple approaches, including the impact of patient and parent perspective on within scale changes in items based on complete loss of function and deterioration of function, and provides new insight on evaluation of differences in these widely used outcome measure in DMD

Maintaining function.

Distribution of participant responses for significant change as minimum number of items on NSAA for maintenance of function (i.e., preventing a change in score from 2 to 1). The x-axis represents minimum number of sub items for which maintaining the activity was meaningful for a parent (red) and for a patient with DMD (blue).</p

Estimates of MCID for NSAA (linearized scale) based on distribution methods.

Estimates of MCID for NSAA (linearized scale) based on distribution methods.</p

Estimates of MCID for NSAA (raw score) and 6MWD based on distribution methods.

Estimates of MCID for NSAA (raw score) and 6MWD based on distribution methods.</p