Edith Kaplan

Normative data on the boston diagnostic aphasia examination, parietal lobe battery, and the boston naming Test

Abstract This report describes normative data for the Boston Diagnostic Aphasia Examination, the “Parietal Lobe Battery” (Goodglass & Kaplan, 1972), and the Boston Naming Test (Kaplan, Goodglass, & Weintraub, 1978). These tests were administered to 147 neurologically normal adult males, who were right-handed and native English-speaking. For each age and education group, means, standard deviations, and the range are reported. The lowest score for each group is suggested as a cut-off below which impairment may be suspected. Differences among age and education groups are specified and briefly discussed.

Reliability and validity of the Delis-Kaplan Executive Function System: An update

A critical endeavor in every health-related field is the continued development of new technologies and instrumentation for improving diagnosis and treatment. For example, the field of neuroimaging has made astonishing advances with procedures such as functional MRI, MR spectroscopy, and MR diffusion tensor imaging. The field of neuropsychology has also recognized the importance of continually striving to develop new, more sensitive clinical measures. At the same time, the development of new tests or procedures does not guarantee that the instruments represent improvements in diagnosis or treatment. For this reason, ongoing studies of reliability and validity of new diagnostic instruments are also an important part of research in all health-related fields.

Developmental sex differences in verbal learning.

Although sex differences in verbal learning and memory have been reported in adults, much less is known about when these sex differences emerge and how they develop. In this study, 401 boys and 410 girls between the ages of 5 and 16 years were administered the California Verbal Learning Test--Childrens Version. Sex differences were found at all age levels. Girls performed better than boys on all of the immediate and delayed recall trials and on the delayed recognition trial. Girls were also more likely than boys to use a semantic clustering strategy and displayed more effective long-term memory mechanisms. Boys made more intrusion errors and displayed greater vulnerability to interference between the 2 test lists. Because boys had higher mean scores on Wechsler Intelligence Scale for Children--Revised Vocabulary, the observed female superiority in verbal learning could not be attributed to sex differences in overall word knowledge.

Methodological issues in screening for dementia: The problem of education adjustment

The methodological problems of developing efficient and unbiased screening methods for population-based studies of dementia have received scant attention. The potential advantages of education-adjusted screening methods are discussed. The implications for adjustment techniques of a negative correlation of educational attainment with age are emphasized. Two education adjustment methods, a stratified regression method and a nonparametric method, which take the age-education correlation into account are described, compared, and illustrated.

Age effects on Executive ability

Heterogeneity of executive tasks has made it difficult to determine whether there are age-related declines in executive functioning. To address this issue, 112 individuals, 20-79 years old, took the California Trail Making Test (CTMT) and the California Stroop Test (CST), subtests of the Delis-Kaplan Executive Function Scale (D. C. Delis, E. Kaplan, & J. H. Kramer, in press) that include measurement of component skills embedded in the executive function tasks. Multiple regression analyses revealed that after controlling for component skills, age had a significant effect on the executive requirement of the CST, namely speed on the interference condition. Age did not affect switching performance on the letter-number condition of the CTMT. Additional analyses revealed that age was significantly associated with commission of certain types of errors. This study confirms the importance of partialing out components in the assessment of multidimensional cognitive tasks, particularly when making age comparisons. It also emphasizes specificity over generalizability when examining the impact of age on cognition.

Memory impairment in multiple sclerosis.

We compared the performance of 50 multiple sclerosis (MS) patients and 35 normal controls on a variety of memory tasks to determine the nature and severity of memory deficits in the MS patients and the proportion of patients affected. We also determined the relationship between memory and other cognitive functions, demographic factors, disease characteristics, depression, and psychoactive medication. We found significant differences between patients and controls on almost all memory tests. Patterns of learning, effects of interference, and improvement with cuing were similar for both groups. Thirty percent of patients showed severe memory impairment, 30% were moderately impaired, and 40% were mildly or not impaired. Memory dysfunction was related to impairment of other cognitive functions, lower socioeconomic status, chronic progressive type of MS, and use of antianxiety medication, but not to severity of disability, duration of MS symptoms or depression.

A Nine—Word dementia version of the california verbal learning test

Abstract The validity of an experimental 9-word version of the California Verbal Learning Test (CVLT) was investigated. The construct validity of the 9-word CVLT was assessed with a principal component analysis (PCA) on a sample of nondemented subjects. A three—factor solution, related to immediate free recall, delayed recall and recognition, and intrusion errors was produced. Construct validity was also assessed by comparing subjects with probable Alzheimers disease (AD), probable ischemic vascular dementia (IVD), and a normal control (NC) group. AD subjects evidenced little learning on immediate free recall test conditions, made no improvement on cued recall or recognition test conditions, and produced copious amounts of intrusion errors. IVD subjects performed similarly to AD subjects on immediate free recall test conditions, but improved on all cued recall and recognition test conditions, and made significantly fewer intrusion errors. The NC group was vastly superior to both groups of demented subjec...

The Boston qualitative scoring system for the Rey-Osterrieth complex figure: Description and interrater reliability

Abstract This report describes a qualitative scoring method for the Rey-Osterrieth Complex Figure (ROCF) that provides scores for fragmentation, planning, organization, presence and accuracy of various features, placement, size distortions, perseveration, confabulation, rotation, neatness, symmetry, and immediate and delayed retention. Interrater reliability is reported for productions drawn by 60 adolescents and adults. Each production received 16 initial scores based on specific criteria. Six additional summary scores were then calculated using scores from all three conditions (i.e., copy, immediate, and delayed recalls). Kappa statistics and intraclass correlations indicated excellent interrater reliability. In sum, the Boston Qualitative Scoring System for the ROCF appears to be a highly reliable and informative method for scoring this widely used instrument.

Assessment of Cognitive Deficit in the Brain-Injured Patient

The cognitive abilities of the individual after brain injury are a consequence of a complex interaction between the premorbid anatomical organization of cerebral functions and the site or sites of damage to the brain, and are reflected by the strategies which the patient brings to bear on the tasks that we employ to probe these abilities. With respect to the first of these factors, some of the abilities which we conceptualize are readily defined in terms of a specific high-order sensory or motor function (e.g., “the ability to recognize faces”), and their loss corresponds to damage to well-defined structures (in the case cited, to bilateral damage in the visual association cortex). Other functions (e.g., new learning, abstract thinking) are not clearly localized, and their degree of deficit is more a function of lesion size than location, although increasing size of lesions may be more damaging in some zones than others. Moreover, the range of cognitive aftereffects of brain injury includes not only deficits in definable capacities but also “positive” symptoms (e.g., perseveration, confabulation, unilateral neglect). To ascribe these symptoms to a deficit in a preexisting capacity requires that we generate ad hoc normal processes whose disruption by brain damage is postulated.

Clock drawing errors in dementia: neuropsychological and neuroanatomical considerations.

Objectives:A clock drawing test scoring system is presented to explore the neuropsychological/neuroanatomic components underlying clock drawing in patients initially diagnosed with Alzheimer disease, ischemic vascular dementia associated with white matter alterations, and Parkinson disease. Methods:Fourteen clock drawing test errors were scored to create 4 clock drawing test subscales that assess different underlying cognitive operations. Results:In the command condition, errors on the Time subscale were correlated with impairment on executive control measures. In the copy condition, errors on the Perseveration/Pull to Stimulus subscale was also correlated with executive control measures. Patients presenting with mild (low) magnetic resonance imaging white matter alterations, significant (high) white matter alterations, and Parkinson disease were compared. In the command condition, the low white matter alterations group made fewer total errors than the Parkinson disease group. In the copy condition, the low white matter alterations group made fewer errors on the Time, Spatial Layout, and Perseveration/Pull to Stimulus clock drawing test subscales than the high white matter alterations or Parkinson disease groups. Few differences were noted between the high white matter alterations and Parkinson disease groups. Discussion:Our data suggest that heavy demands on executive control associated with the interruption of large-scale cortical–subcortical neural networks underlie impairment in clock drawing in mild dementia.