Neuropsychological Assessment of Ethnic-Minorities

Antonio E. Puente

UNC-Wilmington

North Carolina A & T University

April 14, 2000

Background & Confounds

• Puente’s Biases

• A Matter of Perspective: The Case of Elian

Gonzalez

• Defining Race & Ethnicity

History of Neuropsychology

• Organizations: INS, NAN, Division 40 of

APA

• Personnel: Women and Ethnic-Minorities

• Publications: Books & Journals

Fundamental Assumptions of Confounding Variables

• Age

• Lateral Dominance

• Education

• Sex

• Culture & Ethnicity

Potential Problems

• Socio-Economic Issues

• Educational Attainment

• Acculturation

• Criterion and Predictive Validity: What are We Measuring and Who is the Reference Sample

Interviewing Strategies

• Engaging the Patient & the Family

• The Use of Translators and Secondary Information

• Miscommunication & Psychopathology

• Structured Vs Unstructured Approaches

• Indirect and Non-Traditional Measures of Competence

Testing: General Guidelines

• Use Most Recent Version• Administer the Entire Test• Test the Language Selected by the Patient• Evaluate Within a Bio-Psycho-Social Context• Interpret Empirically Realizing the Problems

of Reference Groups• Use a Variety of Tests to Form Conclusions

Testing: Bias

• Inappropriate Content

• Inappropriate Reference Samples

• Examiner and Language Bias

• Measurement of Different Constructs

• Differential Predictive Validity

The Problem of Cognitive Equivalence

• What is the Criterion Reference Value?

• Are We Measuring Acculturation or

Neuropsychological Pathology?

• Are Language and Concepts Similar?

Selected Neuropsychological Tests

• Communication

• Memory

• Spatial & Praxic

• Cognition

• Intellectual

• Battery

Intellectual Tests

• WAIS

• WISC

• WPPSI

• Bayley

• Otis

• Factor “g”

Ethical, Training & Policy Issues

• Personnel & Pipeline Issues: Where is Our Future

• Increase the Number of Tests and Norms Currently Available

• Encourage Publishing Companies to Support These Issues

• Support the Research that Provides the Foundation for Clinical Activity

• Teach Students about Ethnic Diversity in Both Clinical and Academic Settings

• Being “Aware” is Simply Not Enough

Summary

• Defining Minority

• Changing Demographics

• Multi-Dimensional Problems

• The Question of Cognitive Equivalence

• Importance of Using a Variety of Tests and

Sources of Information