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MAJOR ASSESSMENT TOOLS IN CLINICAL PSYCHOLOGY

MAJOR ASSESSMENT TOOLS


• Clinicians use different methods of assessment to arrive at diagnoses,
including
• interviews,
• psychological testing,
• self-report questionnaires,
• behavioral measures, and physiological measures. A careful
assessment provides a wealth of information about clients’
personalities and cognitive functioning. This information helps
clinicians acquire a broader understanding of their clients’ problems
and recommend appropriate forms of treatment.
• In most cases, the formal assessment involves one or more
clinical interviews with the client, leading to a diagnostic
impression and a treatment plan.
• In some cases, more formal psychological testing probes the
client’s psychological problems and intellectual, personality, and

neuropsychological functioning.
• Many tests, questionnaires, inventories, interviews, and other
procedures have been developed for the clinical assessment.
• Some assessment procedures, such as projective tests and
unstructured clinical interviews, tend to be highly inferential. In
using these assessment procedures, the practitioner makes
inferences from responses to stimuli and questions in order to
construct idiographic representations of the individual being
assessed.
Psychological Tests
• A psychological test is a structured method of assessment used to
evaluate reasonably stable traits, such as intelligence and
personality.
• Tests are usually standardized on large numbers of subjects and
provide norms that compare clients’ scores with the average.
• By comparing test results from samples of people who are free of
psychological disorders with those of people who have
diagnosable psychological disorders, we may gain some insights
into the types of response patterns that are indicative of
abnormal behavior.
Though there are many types of tests, it is divided in to
three major categories.
• personality inventories
• projective tests
• intelligence tests
• Test: the term test should be used only for those
procedures in which test takers response are evaluated
based on their correctness of their response.
• Inventory: instruments whose response are neither
evaluated nor scored as right or wrong or pass or fail are
called inventories, questionnaires, survey and checklist.
• Battery: it refers a group of subtest together in different
sections like a test to check calculation ability, abstract
thinking and intelligence.
Personality inventories
• According to G.W. Allport personality is a dynamic organization
inside the person of psycho-physical systems that creates the
person's characteristics, patterns of behavior, thoughts and
feelings.
• In personality inventories a person is asked to complete a self
report questionnaire indicating whether statements assessing
habitual tendencies applied to him /her or not.
• Clinicians use personality tests to learn more about the client’s
underlying personality traits, needs, interests, and concerns.
1.1 Minnesota Multiphasic Personality Inventory (MMPI-2)
• The MMPI-2 contains more than 500 true-false statements that assess
interests, habits, family relationships, physical (somatic) complaints,
attitudes, beliefs, and behaviors characteristic of psychological
disorders.
• It is widely used as a test of personality as well as to assist clinicians
in diagnosing abnormal behavior patterns.
• The MMPI-2 consists of a number of individual scales comprised of
items that tended to be answered differently by members of carefully
selected diagnostic groups, such as patients diagnosed with
schizophrenia or depression, than by members of reference groups.
• MMPI is used in a wide variety of settings such as criminal justice

system, correction system, selecting people who have sensitive

positions (like pilots, policeman, nuclear power workers, fire

fighters…)and family marriage counseling.

• MMPI is administered for those who are above 18 years old,

those who have average IQ and those who are grade 8 and above.
• The items on the MMPI are divided into various clinical scales.
• The MMPI-2 also includes validity scales that assess tendencies
to distort test responses in a favorable (“faking good”) or
unfavorable (“faking bad”) direction.
• Other scales on the tests, called content scales, measure an
individual’s specific complaints and concerns, such as anxiety,

anger, family problems, and problems of low self-esteem.


• The original MMPI had 13 standard scales, of which 3 related to

validity and 10 related to clinical or personality index.

• The recent MMPI-2 have maintained the original 10 clinical

/personality scales/ as well as the original 3 validity scales, but

the total number of validity scales has been increased.

• The clinical and personality scales are known both by their scale

numbers and scale abbreviation.


Table 4 validity, basic (Clinical) and content MMPI

Name Abbreviation Scale No. No. of items


Validity scales
Cannot say ?
Variable response inconsistency VRIN 98
True response inconsistency TRIN 40
Lie L 15
Infrequency F 60
Correction K 30
F back F(b) 40
Basic (clinical ) Scales
Hypochondriasis Hs 1 32
Depression D 2 57
Hysteria Hy 3 60
Psychopathic deviant Pd 4 50
Masculinity –femininity Mf 5 56
Paranoia Pa 6 40
Psychasthenia Pt 7 48
Schizophrenia Sc 8 78
Hypomania Ma 9 46
Social introversion Si 0 69
MMPI-2 Scales and Personality Dimension Measured Scale Name Personality
• l Dimension Measured
Validity Scales
? (Cannot Say) Number of items unanswered
L (Lie) Overly positive self report
F(Validity) Admitting to many problems
K (Correction) Defensiveness
Clinical Scales
1 Hypochondriasis (Hs) Concern regarding bodily functioning
2 Depression (D) Hopelessness, pessimism
3 Conversion Hysteria (Hy) Psychological conflict and distress manifested as somatic
problem
4 Psychopathic Deviate (Pd) Oppositional, disregard for social convention
5 Masculinity-Feminity (Mf) Traditional masculine or feminine interests
6 Paranoia (Pa) Mistrust, suspiciousness
7 Psychasthenia (Pt) Fears, guilt, anxiety
8 Schizophrenia (Sc) Idiosyncratic thinking, unusual thoughts & behavior
9 Hypomania (Ma) Overactivity, emotional excitement
0 Social Introversion (Si) Shy, insecurity
Validity scales
• The MMPI was one of the first test to develop scales to detect whether
respondents were answering in such a manner as to invalidate the overall
results.
The? “scale” cannot say; Cs)
• The ? Scale is not a formal scale but merely represents the number of items
left unanswered on the profile sheet. If 30 or more items are left
unanswered the protocol is most likely invalid and no further interpretations
should be attempted since insufficient number of items have been
responded which means
• To minimize the number of ? responses, the clients should be encouraged to

answer all questions.


VRIN (Variable response inconsistency)
• It comprises pairs of selected questions that would be expected
to be answered in a consistent manner if the person is
approaching the test in a valid manner.
• Each pair of items is either similar or opposite in content. It would
be expected that similar items would be answered in the same
direction.
• A high number of inconsistent responses suggest indiscriminating
response.
TRIN (True response inconsistency)
• In MMPI-2 TRIN scale are like VRIN scale in comprising
pairs of items. However, only pairs with opposite
contents are included
The F scale (infrequency)
• The F scale measures the extent to which a person answers in an
unusual and deviant manner.

• Example a response is scored if the client answers “True” to item


49, “it would be better if almost all laws were thrown away” or
“False” to 64 “I like to visit places where I have never been
before.”

• Low score on F indicates that the clients perceive the world as


most other people do. However, if their history suggests

pathology, they might be denying difficulties.


Fb (F back) scale
• It was designed to identify a “fake bad” mode of responding for
the last 197 items.
• High score suggests the person was answering the items in an
unusual mode/ the person is exaggerating his or her pathology/.
The L (Lie) scale
• The L or lie scale consists of 15 items that indicates the extent to
which a client is attempting to describe himself or herself in an
realistically positive manner. High score describe clients in an
overly perfectionist and idealized manner.
The K (correction) scale

• The k scale was designed to detect clients who are describing themselves

in overly positive terms.

• It, therefore, has similarity with the L scale.

• The k scale however, is more effective. More intelligent and

psychologically sophisticated persons might have somewhat high K

scores.

• Elevation on k can also represent ego defensiveness and guardedness.

• Low scores suggest a fake bad profile in which the person exaggerates his

or her pathology.
Clinical scales
Scale 1 Hypochondriasis (Hs)

• Scale 1 was originally designed to distinguish hypochondriac from other


types of psychiatric patients. High score indicates not only high concern
of illness but also likely to be egocentric, immature, pessimistic

Scale 2 Depression (D)

• This scale is organized in around the areas of physical slowness,


subjective feelings of depression, lack of interest, and physical
malfunctioning. High score indicates difficulty in one or more of these
areas.
Scale 3 Hysteria (Hy)
• It was designed to identify patients who had developed a
psychologically based sensory or motor disorder.
• The 60 items primarily involve specific physical complaints and a
defensive denial of emotional or interpersonal difficulties.
Scale 4 Psychopathic deviate (Pd)
• The purpose of scale 4 is to assess the person’s general level of
social adjustment.
• The questions deal with areas such as degree of alienation from
family, social gathering, difficulties with school and authority
figures and alienation from self and society.
• The original purpose of scale was to distinguish those persons
who had continuing legal difficulties and extensive alcohol and
drug abuses.
Scale 5 Masculinity – femininity (Mf)

•It was originally designed to identify males who were having difficulty
with homosexual feelings and gender identity confusion

• However, it has been largely unsuccessful because a high score does


not seem clearly and necessarily relate to a person's sexual
preferences.

•Instead, it relates to the degree to which a person endorse item


related to traditional masculine or feminine roles or interests.

•High score on scale 5 for males never be used to diagnose


homosexuality.
Scale 6 Paranoia (Pa)
• Scale 6 was designed to identify persons with paranoid
conditions or states.
• It measures a person's degree of interpersonal sensitivity, self
righteousness, and suspiciousness. Many of the 40 items center
on areas such as delusion of reference, delusional beliefs,
pervasive suspiciousness, and feeling of persecution, grandiose
self beliefs, and interpersonal rigidity.
• Some of the items deal with overt psychotic content, other less
extreme questions asks information related to perceived hidden
motives.
Scale 7 Psychasthenia (Pt)
• The 48 items on scale 7 were originally designed to measure the
syndrome of Psychasthenia.
• It consists of compulsions, obsessions, unreasonable fears, and
excessive doubts. Scale 7 measures more overt fears and anxieties
that the person might be experiencing. Persons having OCD could
score quite low on 7.
Scale 8 Schizophrenia (Sc)
• Scale 8 was originally designed to identify persons who were
experiencing schizophrenic or schizophrenic like conditions. This
goal has been partially successful in that a diagnosis of
schizophrenia is raised as a possibility in the case of persons who
score extremely high.
• The item assess areas such as social alienation, apathy, poor family
relations, unusual thought processes and peculiarities in
perception. Other questions are intended to measure reduced
efficiency, difficulties in concentration, general fears and worries,
inability to cope, and difficulties with impulse control.
Scale 9 Hypomania (Ma)
• The 46 items on scale 9 were originally developed to identify
persons experiencing hypo manic symptoms. The symptoms
might include cyclical periods of euphoria, increased irritability,
excessive unproductive activity that might be used as distraction
to stave off an impending depression.
Scale 0 Social introversion (Si)
• This scale was developed from the responses of college students
on questions relating to introversion –extraversion continuum.
• High score suggests that the respondent is shy, has limited social
skills, feels uncomfortable in social interactions, interaction with
opposite sex and withdraws from many interpersonal situations.
• They would prefer to be alone or with a few close friends than

with a large group.


• Interpretation procedure

• The examiner should note the length of time required to


complete the test.

• For a mildly disturbed person who is 18 years or older with an


average IQ and eighth –grade education, the total completion
time for the MMP-2 should be approximately 90 minutes.
Computer administrations are usually 15 to 30 minutes shorter
(60 to 75 minute in total).

• If two or more hours are required for the MMPI -2 the


following interpretive possibilities must be considered.
• Major psychological disturbance, particularly a severe depression or
functional psychosis.

• Obsessive indecision

• Below average IQ or poor reading ability resulting from an inadequate


educational background

• Cerebral impairment.

• If on the other hand, an examinee finishes in less than an hour, the examiner
should suspect an invalid profile, an impulsive personality, or both.

• Note ; any erasures or pencil points on the answer sheet. The presence of
few of these signs indicate that the person took the test seriously where as a
great number of erasures may reflect obsessive compulsive tendencies.
2 Projective Tests
• A projective test, unlike an objective test, offers no clear, specified
response options.
• Clients are presented with ambiguous stimuli, such as inkblots,
and asked to respond to them.
• The word projective is used because these personality tests
derive from the psychodynamic belief that people impose, or
“project,” their own psychological needs, drives, and motives,
much of which lie in the unconscious, onto their interpretations
of ambiguous stimuli.
• The psychodynamic model holds that potentially disturbing
impulses and wishes, often of a sexual or aggressive nature, are
often hidden from consciousness by our defense mechanisms.

• Indirect methods of assessment, however, such as projective


tests, may offer clues to unconscious processes.

• Many projective tests have been developed . The two most


prominent projective techniques are the

• Rorschach Inkblot Test and

• the Thematic Apperception Test (TAT).


2.1 Rorschach Test
• The Rorschach test was developed by a Swiss psychiatrist,
Hermann Rorschach (1884–1922). As a child, Rorschach was
fascinated by the game of dripping ink on paper and folding the
paper to make symmetrical figures.
• He noted that people saw different things in the same blot, and
he believed their “percepts” reflected their personalities as well
as the stimulus cues provided by the blot
• As a psychiatrist, Rorschach experimented with hundreds of blots
to identify those that could help in the diagnosis of psychological
problems.
• He finally found a group of 15 blots that seemed to do the job
and could be administered in a single session.
• Ten blots are used today because Rorschach’s publisher did not
have the funds to reproduce all 15 blots in the first edition of the
text on the subject.
• Rorschach never had the opportunity to learn how popular and
influential his inkblot test would become. Sadly, 7 months after
the publication of the test that bears his name, Rorschach died at
age 37 of complications from a ruptured appendix
• Five of the inkblots are black and white, and the other five have

color.

• Each inkblot is printed on a separate card, which is handed to

subjects in sequence.

• Subjects are asked to tell the examiner

• what the blot might be or

• what it reminds them of.

• Then, they are asked to explain what features of the blot (its

color, form, or texture) they used to form their perceptions.


• Clinicians who use the Rorschach, form interpretations based on

the content and the form of the responses.

• For example, they may infer that people who use the entire blot in

their responses show an ability to integrate events in meaningful

ways.

• Those who focus on minor details of the blots may have obsessive–

compulsive tendencies,

• whereas clients who respond to the negative (white) spaces may

see things in their own idiosyncratic ways, suggesting underlying

negativism or stubbornness.
• People who see movement in the blots may be revealing
intelligence and creativity.
• Content analysis may shed light on underlying conflicts.

For example, adult clients who see animals but no people may have
problems relating to people.
• Clients who appear confused about whether or not percepts of
people are male or female may, according to psychodynamic
theory, be in conflict over their own gender identity

2.2 The Thematic Apperception Test (TAT)
• The Thematic Apperception Test (TAT) was developed by psychologist
Henry Murray (1943) at Harvard University in the 1930s.
• Apperception is a French word that can be translated as “interpreting
(new ideas or impressions) on the basis of existing ideas (cognitive
structures) and past experience.”
• The TAT consists of a series of cards, each depicting an ambiguous
scene.
• It is assumed that clients’ responses to the cards will reflect their
experiences and outlooks on life—and, perhaps, shed light on their
deep-seated needs and conflicts.
Respondents are asked to describe
• what is happening in each scene,
• what led up to it,
• what the characters are thinking and feeling, and
• what will happen next.
• Psychodynamic theorists believe that people will identify with the character
in their stories and project underlying psychological needs and conflicts into
their responses.
• More superficially, the stories suggest how respondents might interpret or
behave in similar situations in their own lives.
• TAT results may also be suggestive of clients’ attitudes toward others,
particularly family members and lovers.
• TAT Case Illustration

• Card 3BM Looks like a little boy crying for something he can’t have.

(Why is he crying?) Probably because he can’t go somewhere. (How

will it turn out?) Probably sit there and sob him self [sic] to sleep.

• Card 3GF Looks like her boyfriend might have let her down. She

hurt his feelings.He’s closed the door on her. (What did he say?) I

don’t know.

• Card 9GF Girl looks like somebody’s run off and left her. She’s ready

for a dance. Maid is watching to see where she goes. (Why run off?)

Probably because she wasn’t ready in time.


l
3. Neuropsychological Assessment
• Neuropsychological assessment involves the use of tests to help
determine whether psychological problems reflect underlying
neurological impairment or brain damage.
• When neurological impairment is suspected, a neurological
evaluation may be requested from a neurologist—a medical
doctor who specializes in disorders of the nervous system.
• Neuropsychological testing may be used together with brain-
imaging techniques such as the MRI and CT to shed light on
relationships between brain function and underlying
abnormalities
The results of neuropsychological testing may not only
suggest whether patients suffer from brain damage but
also point to the parts of the brain that may be affected.
3.1 Bender Visual Motor Gestalt Test
• One of the first neuropsychological tests to be developed
and still one of the most widely used neuropsychological
tests is the Bender Visual Motor Gestalt Test, now in a
second edition, the Bender-Gestalt II
Purpose
• The Bender-Gestalt is used to evaluate visual-motor maturity and
to screen children for developmental delays. The test is also used
to assess brain damage and neurological deficits. Individuals who
have suffered a traumatic brain injury may be given the Bender-
Gestalt as part of a battery of neuropsychological measures, or
tests.
The Bender-Gestalt is sometimes used in conjunction with other
personality tests to determine the presence of emotional and
psychiatric disturbances such as schizophrenia.
• Precautions
• Psychometric testing requires a clinically trained examiner. The
Bender Visual Motor Gestalt Test should be administered and
interpreted by a trained psychologist or psychiatrist. The Bender-
Gestalt should always be employed as only one element of a
complete battery of psychological or developmental tests, and

should never be used alone as the sole basis for a diagnosis.


• The standard Bender Visual Motor Gestalt test consists of
nine figures, each on its own 3 × 5 card.
• An examiner presents each figure to the test subject one at
a time and asks the subject to copy it onto a single piece of
blank paper.
• The only instruction given to the subject is that he or she
should make the best reproduction of the figure possible.
• The test is not timed, although standard administration
time is typically 10-20 minutes.
• The examiner then asks the client to reproduce the
designs from memory, because neurological damage can
impair memory functioning.
• Although the Bender remains a convenient and
economical means of uncovering possible organic
impairment, more sophisticated test batteries have been
developed for this purpose, including the widely used
Halstead Reitan Neuropsychological Battery.
• After testing is complete, the results are scored based
on accuracy and organization.
• Interpretation depends on the form of the test in use.
Common features considered in evaluating the drawings
are rotation, distortion, symmetry, and perseveration.
• As an example, a patient with frontal lobe injury may
reproduce the same pattern over and over
(perseveration).
• The Bender-Gestalt can also be administered in a group setting.
• In group testing, the figures are shown to test subjects with a
slide projector, in a test booklet, or on larger versions of the
individual test cards.
• Both the individual and group- administered Bender-Gestalt
evaluation may take place in either an outpatient or hospital
setting.
4. The Halstead-Reitan Neuropsychological Test Battery
• Definition

• The Halstead-Reitan Neuropsychological Test Battery is a fixed set


of eight tests used to evaluate brain and nervous system
functioning in individuals aged 15 years and older.
• Children's versions are the Halstead Neuropsychological Test
Battery for Older Children (ages nine to 14) and the Reitan
Indiana Neuropsychological Test Battery (ages five to eight).
• Purpose
• Neuropsychological functioning refers to the ability of the
nervous system and brain to process and interpret information
received through the senses.
• The Halstead-Reitan evaluates a wide range of nervous system
and brain functions, including: visual, auditory, and tactual input;
verbal communication; spatial and sequential perception; the
ability to analyze information, form mental concepts, and make
judgments; motor output; and attention, concentration, and
memory.
• The Halstead-Reitan is typically used to evaluate individuals with
suspected brain damage.
• The battery also provides useful information regarding the cause
of damage (for example, closed head injury, alcohol abuse,
Alzheimer's disorder, stroke ), which part of the brain was
damaged, whether the damage occurred during childhood
development, and whether the damage is getting worse, staying
the same, or getting better.
• Information regarding the severity of impairment and areas of
personal strengths can be used to develop plans for rehabilitation
or care.
Precautions

• Due to its complexity, the Halstead-Reitan requires


administration by a professional examiner and
interpretation by a trained psychologist .

• Test results are affected by the examinee's age, education


level, intellectual ability, and—to some extent—gender or
ethnicity, which should always be taken into account.

• overall, the battery requires five to six hours to complete,


involving considerable patience, stamina, and cost
Description
• The Halstead-Reitan has been researched more than any other
neuropsychological test battery.
• Research continues to support its ability to detect impairment
accurately in a large range of neuropsychological functions.
• The eight core tests are described below, followed by a list of
tests commonly used in combination with the basic battery.
1 Category Test
• A total of 208 pictures consisting of geometric figures are
presented.
• For each picture, individuals are asked to decide whether they are
reminded of the number 1, 2, 3, or 4. They press a key that
corresponds to their number of choice. If they chose correctly, a
chime sounds. If they chose incorrectly, a buzzer sounds. The
pictures are presented in seven subtests.
• The key to this test is that one principle, or common
characteristic, underlies each subtest. The numbers 1, 2, 3, and 4
represent the possible principles.
• If individuals are able to recognize the correct principle in one
picture, they will respond correctly for the remaining pictures in
that subtest.
• The next subtest may have the same or a different underlying
principle, and individuals must again try to determine that
principle using the feedback of the chime and buzzer.
• The Category Test is considered the battery's most effective test
for detecting brain damage, but does not help determine where
the problem is occurring in the brain.
• The test evaluates abstraction ability, or the ability to draw

specific conclusions from general information.

• Scoring involves recording the number of errors.


2 . Tactual Performance Test
• A form board containing ten cut-out shapes, and ten wooden
blocks matching those shapes are placed in front of a blindfolded
individual.
• Individuals are then instructed to use only their dominant hand to
place the blocks in their appropriate space on the form board.
• The same procedure is repeated using only the non-dominant
hand, and then using both hands.
• Finally, the form board and blocks are removed, followed by the
blindfold. From memory, the individual is asked to draw the form
board and the shapes in their proper locations.
• The test usually takes anywhere from 15 to 50 minutes to
complete. There is a time limit of 15 minutes for each trial, or
each performance segment.
• Other names for this test are the Form Board Test and the Seguin-
Goddard Form board. It evaluates sensory ability, memory for
shapes and spatial location, motor functions, and the brain's
ability to transfer information between its two hemispheres.
• this test also helps determine on which side of the brain damage
may have occurred.
• For children under the age of 15, only six shapes are used.
• Scoring involves recording the time to complete each of the three
blindfolded trials and the total time for all trials combined (time
score), the number of shapes recalled (memory score), and the
number of shapes drawn in their correct locations (localization
score).
• Generally, the trial for the non-dominant hand should be
between 20 to 30 percent faster than the trial for the dominant
hand, due to the benefit of practice. If the non-dominant hand is
slower than the dominant hand or more than 30 percent faster
than the dominant hand, brain damage is possible.
3. Trail Making Test

• This test consists of two parts.

• Part A is a page with 25 numbered circles randomly arranged.


Individuals are instructed to draw lines between the circles in
increasing sequential order until they reach the circle labeled "End."

• Part B is a page with circles containing the letters A through L and 13


numbered circles intermixed and randomly arranged. Individuals are
instructed to connect the circles by drawing lines alternating between
numbers and letters in sequential order, until they reach the circle
labeled "End."

• The test takes approximately five to 10 minutes to complete.


• The test evaluates information processing speed, visual scanning
 ability, integration of visual and motor functions, letter and
number recognition and sequencing, and the ability to maintain
two different trains of thought.
• The test can be administered orally if an individual is incapable of
writing
• Scoring is simply the time to complete each part. For adults,
scores above 40 seconds for Part A and 91 seconds for Part B have
traditionally indicated brain impairment
4. Finger Tapping Test
• Individuals place their dominant hand palm down, fingers extended, with
the index finger resting on a lever that is attached to a counting device.
• Individuals are instructed to tap their index finger as quickly as possible
for ten seconds, keeping the hand and arm stationary.
• This trial is repeated five to 10 times, until the examiner has collected
counts for five consecutive trials that are within five taps of each other.
• Before starting the test, individuals are given a practice session. They are
also given brief rests between each 10-second trial, and one to two-
minute rests after every third trial.
• This entire procedure is repeated with the non-dominant hand. The test
takes approximately ten minutes to complete.
• In general, the dominant hand should perform ten percent
better than the non-dominant hand. Yet this is not always the
case, especially with left-handed individuals.
• Males and younger people tend to perform better than
females and older people.
• Interpretation should also consider education level,
intelligence, fatigue , general weakness or lack of
coordination, depression, and injuries to the shoulders, arms,
or hands. This test should only be interpreted in combination
with other tests in the battery.
5. Rhythm Test
• Thirty pairs of tape-recorded, non-verbal sounds are presented.

• For each pair, individuals decide if the two sounds are the same
or different, marking "S" or "D" respectively on their answer
sheets.
• The pairs are grouped into three subtests. This test is also called
the Seashore Rhythm Test, and is based on the Seashore Tests of
Musical Ability.
• It evaluates auditory attention and concentration, and the ability
to discriminate between non-verbal sounds.
• The test helps detect brain damage, but not the location of
damage. Adequate hearing and visual abilities are needed to take
this test.
• Scoring is based on number of correct items, with higher scores
indicating less damage or good recovery.

6. Speech Sounds Perception Test
• Sixty tape-recorded nonsense syllables containing the sound "ee"
(for example, "meer" and "weem") are presented.
• After each syllable, individuals underline, from a set of four written
syllables, the spelling that represents the syllable they heard.
• This test evaluates auditory attention and concentration and the
ability to discriminate between verbal sounds.
• It provides some information regarding specific areas of brain
damage, and may also indicate attention deficits or hearing loss.
Scoring and interpretation are similar to that used for the Rhythm
Test. The children's version contains fewer syllable choices.
7. Reitan-Indiana Aphasia Screening Test
• Aphasia is the loss of ability to understand or use written or
spoken language, due to brain damage or deterioration. In this
test, individuals are presented with a variety of questions and
tasks that would be easy for someone without impairment.
• Examples of test items include verbally naming pictures, writing
the name of a picture without saying the name aloud, reading
printed material of increasing length, repeating words stated
by the examiner, simple arithmetic problems, drawing shapes
without lifting the pencil, and placing one hand to an area on the
opposite side of the body.
• This test is a modification of the Halstead-Wepman Aphasia
Screening Test.
• It evaluates language-related difficulties, right/left confusion, and
non-verbal tasks.
• A typical scoring procedure is not used because this is a screening
test; its purpose is to detect possible signs of aphasia that may
require further evaluation.
8. Reitan-Klove Sensory-Perceptual Examination
• This test detects whether individuals are unable to perceive stimulation on
one side of the body when both sides are stimulated simultaneously.
• It has tactile, auditory, and visual components involving the ability to

• (a) specify whether touch, sound, or visible movement is occurring on


the right, left, or both sides of the body;
• (b) recall numbers assigned to particular fingers (the examiner assigns
numbers by touching each finger and stating the number with the
individual's eyes closed);
• (c) identify numbers "written" on fingertips while eyes are closed; and
(d) identify the shape of a wooden block placed in one hand by pointing
to its shape on a form board with the opposite hand.

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