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NEPSY-II Presentation – TASP Fall Conference , 2015 NEPSY-II Presentation – TASP Fall Conference , 2015 Presentation Outline • NEPSY-II Overview • How to Administer the NEPSY-II tests • How does the NEPSY-II fit within a Howw to Administeristerterr andan d InterpretInterp school neuropsychological conceptual the NEPSYPSPSYY-II - Part 1 model? Presenter: • A case study illustration Daniel C. Miller, Ph.D., ABPP, ABSNP, NCSP, LSSP 2015 TASP Fall Conference ! " NEPSY-II Authors NEPSY-II Development • Dr. Marit Korkman - Professor of Neuropsychology Department of Psychology, University of Helsinki, Helsinki, Finland & • When many different tests comprise a Abo Academy University, Turku, Finland pediatric neuropsychological battery, the tests are normed on different children. • Dr. Ursula Kirk - Retired Chair of the Neuroscience and • Differences in scores for a child may be Education Program, Teachers College, Columbia University, New York, N.Y. due to differences in the norm groups? • All of the tests in NEPSY-II were co- • Dr. Sally Kemp - Retired from Private Multidisciplinary normed, allowing scores to be compared Practice, specializing in developmental disorders; Adjunct across domains in a test profile: shows Associate Professor, University of Oklahoma College of child’s strengths/weaknesses & Medicine, Tulsa, OK & Adjunct Professor, Health Psychology Department, University of Missouri - performance relative to age-mate peers. Columbia # $ Lurian Tradition (Luria 1973, 1980) Complex Functional Systems NEPSY and NEPSY-II are theoretically-based on Luria’s principles: Complex cognitive functions can be impaired in ways that are comparable to that Draw-A-Man which occurs in the breakdown of a complicated system. Visuomotor • If one sub-component is impaired then complex Body Schema precision & skill functions may be impaired. Kinesthetic & • Identify deficits underlying impaired performance in Visuospatial Tactile Feedback one functional domain that affect performance in Motor Programming Precision other functional domains • Both impaired performance and qualitative behavioral observations are necessary to detect and distinguish Simple Motor Kinesthetic & Vision between primary and secondary deficits. Functioning Tactile Sensation % & Copyright © 2015 Daniel C. Miller, Ph.D. ! NEPSY-II Presentation – TASP Fall Conference , 2015 Learning is a Multifactorial Process NEPSY-II Model Clinician chooses the level of administration: – Core Assessment - Basic, brief overview of a child’s Executive neuropsychological status across all six domains, Memory & Functioning/ looking beyond global scores to subtest performances Learning Attention Language that capture deficits more clearly. – Diagnostic & Selective Assessment - LEARNING In-depth assessment of areas relevant to diagnostic categories or areas desired by examiner Evaluation of Sensorimotor Social Visuospatial – Comprehensive Assessment - neuropsychological status with all subtests for age. Functioning Perception Processing ' ( Psychometric Issues in Neuropsychological Assessments Scoring Features of the NEPSY-II • Neuropsychological tests are designed to measure constructs that are not normally Score Summary : distributed in the general population as they are Single Scaled Scores for each subtest can be used in measures of general cognitive ability. Additional Diagnostic Scores are available. • (e.g. Most motor tasks mastered by 9 years of age - Korkman, Kirk, & Kemp, 2001) Combined Scores can be used to place: • The focus is on differentiating cases in the lower Two scores on the same metric as in time and error end of the distribution to determine the severity or weight one variable more than another of impairment. • Contrast Scores can be used to compare one score to (The findings are of interest when child cannot another across ability levels complete motor task at 9 yr.). ) !* NEPSY-II Test Batteries General Assessments • A General Assessment Battery of tests is • General Assessment Battery generally recommended as a starting point in most school-based assessments. • Diagnostic Assessment Batteries • The General Assessment provides samples of behavior form each of the five • Selective Assessment Batteries functional domains. • The selection of the subtests for inclusion • Full NEPSY-II Administration on the General Assessment Battery was determined by psychometric and clinical considerations. !! !" Copyright © 2015 Daniel C. Miller, Ph.D. " NEPSY-II Presentation – TASP Fall Conference , 2015 General Assessments Diagnostic Assessments Ages 3-4 Ages 5-16 • Comprehension of • Auditory Attention and The NEPSY-II • Learning Differences - Reading Instructions Response Set Scoring • Learning Differences - Math • Design Copying • Comprehension of Instructions Assistant and • Geometric Puzzles • Design Copying Assess Planner • Attention/Concentration • Narrative Memory • Geometric Puzzles can used used • Behavior Management • Speeded Naming • Inhibition to develop an • Language Delays/Disorders assessment • Statue • Memory for Faces (Delayed) plan based on • Perceptual and/or Motor • Visuomotor Precision • Narrative Memory the referral Delays/Disorders • Speeded Naming question • School Readiness • Statue (ages 5-6) (see Table 2.5 in • Social/Interpersonal • Visuomotor Precision (5-12) Manual). Differences • Word List Interference (7-16)!# !$ Example of Diagnostic Assessment for Example of Diagnostic Assessment for Learning Differences - Reading Perceptual/Motor Delays/Disorders Attention and Executive Memory and Learning Attention and Executive Sensorimotor Functioning –Memory of Names/Delayed Functioning –Finger Tapping (5-16) –Aud. Attn & Resp. Set (5-16) (5-16) –Aud. Attn & Resp. Set (5-16) –Imitating Hand Positions (3- –Inhibition (5-16) –Word List Interference (7- –Clocks (7-16) 12) –Statue (3-6) 16) –Design Fluency (5-12) –Manual Motor Seqs (3-12) Language Sensorimotor –Statue (3-6) –Visuomotor Precision (3-12) –Comp. of Instr. (3-16) –Manual Motor Seqs (3-12) Language Social Perception –Oromotor Sequences (3-12) Social Perception (N/A) –Oromotor Sequences (3-12) –Affect Recognition (Opt) (3-16) –Phonological Process. (3-16) Visuospatial Processing Memory and Learning Visuospatial Processing –Speeded Naming (3-16) –Design Copying (3-16) –Memory for –Block Construction (3-16) –Picture Puzzles (7-16) Designs/Delayed (3-16) –Design Copying (3-16) –Geometric Puzzles (3-16) !% !& Selective Assessment Batteries Selective Assessment Batteries • If the referral question is specific to a • A word of caution: children often do not fit neurocognitive deficit such as attentional neatly into diagnostic boxes. processes, a selective assessment battery • Example: a child with an attentional may be used. processing disorder - you would not want to • Subtest selection should be based on limit the assessment just to the attention theory and research findings concerning and executive functions domain - attention characteristics of various disorders and affects all aspects of learning. the primary deficits that may underlie the • It is always a delicate balance in finding impairment in question. the right amount of testing to choose to answer the referral question(s). !' !( Copyright © 2015 Daniel C. Miller, Ph.D. # NEPSY-II Presentation – TASP Fall Conference , 2015 Full Assessment of the NEPSY-II Presentation Outline • Children with known or suspected brain • NEPSY-II Overview damage or dysfunction: • How to Administer the NEPSY-II – cerebral palsy, epilepsy, hydrocephalus, or TBI tests • Neurodevelopmental risk factors: – very low birth weight, birth asphyxia, or drug • How does the NEPSY-II fit within a or alcohol exposure school neuropsychological conceptual • Medical treatments that affect the model? central nervous system: • A case study illustration – Chemotherapy, or radiation. !) "* Subtest Order of Administration Subtest Order of Administration • After the examiner has chosen which tests The order of the subtest administration is are to be administered (e.g., general dependent upon: battery, diagnostic assessment, etc), the – Ability of the child to sustain interest in the tasks. order of the subtests must be determined. – The time lapse between immediate and delayed • The NEPSY-II Test Record Form presents memory tasks is accounted for. the tests in alphabetical order but the – The referral question - do not start an tests should not be automatically assessment battery with a task that measures the child’s known of suspected neurocognitive administered in that order. deficits. Try to start with a task that will be interesting and too challenging for the child in order to build some rapport. "! "" What will you need to Subtest Order of Administration administer the NEPSY-II? Suggestion: • The NEPSY-II Test Kit – Sequentially number at the top of the page in the the NEPSY-II Test Record • A CD player Form the subtests that you have chosen to administer. • A couple of sharpened pencils – Make allowances for the factors identified on the previous slide, • A clipboard specifically the 20-30 minutes required between the immediate and delayed memory tasks. "# "$ Copyright © 2015 Daniel C. Miller, Ph.D. $ NEPSY-II Presentation – TASP Fall Conference , 2015 NEPSY-II Domains Motor Skills in NEPSY-II In NEPSY-II, assessment in this area limited to: – Fine-Motor Coordination and Programming Executive • Capacity to control finger and hand movements Memory & Functioning/ quickly, smoothly, and with precision/ may vary Learning Attention Language across functions. • Necessary for writing, drawing, crafts, some games. May appear awkward and clumsy.
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