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Postscript-Future Directions Postscript-Future Directions To predict the future is a daunting task. At the time of publication of the previous edition of this book I certainly would not have predicted the developments in or the effects of outside forces such as managed care on the field. Perhaps instead of future directions, we should talk of necessary improvements. In general, I think the field will see a greater degree of psychometric sophistication among clinicians and researchers. The increased use of Item Response Theory and Generalizability Theory to evaluate the precision of measurement would be a positive development. Along those lines, the evaluation and conceptualization of validity as a diffractionable entity rather than a monolith will help us to better understand and use the assessment techniques at our disposal. The general conceptualization of a test as a method-construct unit will also aid our understanding. Among the forms of validity, ecological validity will see a much greater emphasis. As behavioral scientists, it is important that we concentrate on our specialty-behavior-and the relationship of behavior to the environment. The greater use of confirmatory factor analysis will also positively impact on assessment methods. Exploratory factor analysis still has a place, but the greater certainty of comparing different factor solutions will help resolve some standing questions. The most obvious direction for future research is to conduct studies that will help elucidate the relationships between traditional neuropsychological assessment results and behaviors in the open environment. This would require the development of methods to evaluate the degree of success in performing the behaviors. Relevant sources of informa­ tion include direct behavioral observation, self-report, and report by significant others. An example of self-report instruments is the Cognitive Failures Questionnaire (Broadbent et al., 1982). An example of report by significant others is the Cognitive Behaviors Rating Scale (Williams, 1987). An ancillary area would be to identify those variables that most likely operate as moderating variables in the relationship between test data and free behavior. Some of these variables, such as speed of information processing, degree of executive control required, and extent of distractions, have already been discussed. Other variables include level of motivation, extent of anxiety, and affective status. The development of assessment techniques may follow two potentially fruitful ave­ nues. First, examination of the task requirements of free behaviors may indicate the direction for future assessment instrument development. An example of this can be found in the everyday memory instrument developed by Crook and Larrabee; the memory instru- 355 356 POSTSCRIPT -FUTURE DIRECTIONS ment developed by Wilson, Cockburn, and Baddeley (1991); or the communication skills instrument developed by Holland (1980). Another direction for instrument development may be similar to the Loewenstein Direct Assessment of Functional Status (Loewenstein et aI., 1989) where behavioral assessment techniques are used to evaluate the capacity of an individual to complete simple behaviors related to everyday functioning. Among the methods used in assessment, the rise of methods to predict premorbid functioning will continue, as will the rise of methods to determine the presence of response bias. We will almost certainly see an explosive growth in the number of instruments available to test children. Furthermore, increased attention can be fruitfully turned to the development and evaluation of interview techniques. So much of our information is derived from the interview and yet there is so much variability possible, both within the same individual and across individuals. These methods need to be evaluated in terms of their reliability and validity, just as has been done in the area of psychiatric diagnosis. Finally, the last step in assessment is the clinical decision-making that goes on when a diagnosis is reached or treatment is suggested. It would benefit the field to study these decision processes with the eventual aim of suggesting mental algorithms. Will these predictions be met? Maybe not. Should they be addressed as suggestions? Definitely. If any students read this book without coming away with ideas for theses, dissertations, or career paths, maybe this Postscript will provide that impetus. References Abell, S.C., Heiberger, A.M., & Johnson, lE. (1994). Cognitive evaluations of young adults by means of human figure drawings: An empirical comparison of two methods. 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Alfano, D.P., Paniak, C.E., & Finlayson, M.A.J. (1993). The MMPI and closed head injury: A neurocorrective approach. Neuropsychiatry, Neuropsychology, and Behovioral Neurology, 6, 111-116. A1legri, R.E, Mangone, C.A., Villavicencio, A.E, Rymberg, S., Taragano, EE., & Baumann, D. (1997). Spanish Boston Naming Test norms. The Clinical Neuropsychologist, n, 416-420. 357 358 REFERENCES Allen, D.N., Huegel, S.G., Seaton, B.E., Goldstein, G., Gurklis, J.A., & van Kammen, D.P. (1998). Confirmatory factor analysis of the WAlS-R in patients with schizophrenia. Schizophrenia Research, 34, 87-94. Allen, S.R., & Thorndike, R.M. (l995a). Stability of the WAlS-R and WISC-III factor structure using cross­ validation of covariance structure models. Journal of Clinical Psychology, 51, 648-657. Allen, S.R. & Thorndike, RM. (1995b). Stability of the WPPSI-R and WISC-III factor structure using cross­ validation of covariance structure models. Journal of Psychoeducational Assessment, 13, 3-20. Allison, H.W., & Allison, S.G. (1954). Personality changes following transorbital lobotomy. Journal ofAbnormal and Social Psychology, 49, 218-223. Altepeter, T. (1985). Use of the PPVT-R for intellectual screening with a preschool pediatric sample. Journal of Pediatric Psychology, 195-198. Altepeter, T., & Handal, P.1. (1985). A factor analytic investigation of the use of the PPVT-R as a measure of general achievement. Journal of Clinical Psychology, 41, 540-543. Altepeter, T., & Handal, P.1. (1986). Use of the PPVT-R for intellectual screening with school-aged children: A caution. Journal of Psychoeducational Assessment, 4, 145-154. Altepeter, T.S., & Johnson, K.A. (1989). Use of the PPVT-R for intellectual screening with adults: A caution. Journal of Psychoeducational Assessment, 7, 39-45. Alterman, A.I., Zaballero, A.R, Lin, M.M., Siddiqui, N., Brown, L.S., Rutherford, M.1., & McDermott, P.A. (1995). Personality Assessment Inventory (PAl) scores of lower-socioeconomic African-American and Latino methadone maintenance patients. Assessment,
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