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NEUROPSYCHOLOGICAL ASSESSMENT ON THE INTERNET/WWW: ADAPTATION FOR PERSONS WITH VISUAL DISABILITY

Paul Jones, Ed.D.
Neuropsychological Assessment Lab
Department of Educational Psychology
University of Nevada, Las Vegas
Las Vegas, NV 89154-3003
Voice: (702) 895-3937
FAX: (702) 895-1658
Email: jones@nevada.edu

Janis Riceberg, M.Ed.
Durango High School
7100 West Dewey Drive
Las Vegas, NV 89113
Voice: (702) 799-5850 ext. 270
FAX: (702) 799-5855
Email: hrxr@aol.com

Introduction:

This paper describes the development of three test instruments which can be administered, scored, and interpreted via the Internet/WWW. Each was designed with specific intent to facilitate equity in application with both the sighted population and persons with visual disability. Two of the instruments, CogAttention and CogMemory, have historical roots in a three-year project, funded by Title IV-C, on assessment for children and adolescents with visual disabilities (Jones, 1980). The third, CogStyle, has roots in a research project focused on strategies to motivate students with visual disability toward careers in mathematics, science, and technology (Jones, 1996). That project, funded by the Department of Energy, was conducted in 1994-95.

Cognitive Attention Test:

CogAttention is a two part measurement of basic attending and organizing of information. Part one uses ten items to test simple pitch discrimination. In the second part, also with ten items, the person hears two series of tones and identifies which tone is different in the second series. CogAttention is based on an auditory competency scale developed as a followup to the Title IV-C project cited above. The intent of the auditory competency test was to provide cognitive screening using stimuli with neither symbolic nor semantic meaning.

CogAttention began as a 32-item auditory competency pretest, administered with a standard ability test in the spring of 1983 to a sample of 249 students enrolled in a comprehensive community college located in a Southwestern state. Prior research suggested that the student body was similar to a general population in cognitive ability, ethnicity, and socioeconomic status.

The ability test data were used in a stratified random sampling process to identify a sample of 100 subjects, selected to approximate a normal distribution. This "normal" sample was then used to choose the items using typical difficulty/discrimination criteria and to create performance norms.

To minimize overinterpretation of raw scores on a short scale, the sten scale was selected for use in normative comparisons. Sten scores of 1-3 are interpreted as low, 4-7 as average, and 8-10 as high. The high and low ranges represent approximately the top and bottom 16% of the general population. On the 20 item scale the split-half reliability estimate was .71 (SEmeas = 1.42). The KR20 reliability estimate was .70 (SEmeas = 1.44). The mean item difficulty was .78. Gender differences were not significant.

The original auditory competency scale was administered using an audio tape. Conversion to a format for administration via the Internet/WWW was completed in 1998. With Java (TM), two forms of the test were prepared. The standard form assumes that a sighted person is interacting with the display (examiner and/or subject) and uses the mouse as the primary response mode with typical graphical user interface. The enabled form is intended to facilitate use by persons with limited vision, using keyboard rather than mouse response and a larger font display. Tones matching those used in the original test were created in the AU file format.

For consistency with other tests being developed in the UNLV Neuropsychological Assessment Lab, a derivative of the sten scale is used to report CogAttention results. The derivative is simply the sten conversion multiplied by 10. This results in a 10 point scale with scores ranging from 10 to 100 in intervals of 10.

The CogAttention Test appears to directly tap the "attention" function in the contemporary PASS theory (Naglieri & Das, 1990) built on Luria's model of neuropsychological functions. In essence this model identifies four functions: (P)roblem solving, (A)ttention, (S)equential processing, and (S)imultaneous processing.

On comparable items in other tests there is significant difference in the performance of normal vs. brain impaired subjects (Golden, Purisch, & Hammeke, 1985). CogAttention part one is clearly consistent with assessment of this attention function. Part two would appear to include elements of both attention and sequential processing, but the two parts of the CogAttention scale loaded on the same factor in factor analytic studies.

Cognitive Memory Test:

CogMemory uses memory span for digits to measure short-term memory, attention, and sequential processing. The subject listens to a series of numbers and then enters the numbers using the keyboard. Memory span for digits is a widely used task in tests of mental ability.

The same procedures and sample used in initial design of CogAttention were used in development of the CogMemory test. After pretesting, eight memory span items were selected. The number of digits in each item ranges from 5 to 9. Assigning one point for each correctly identified digit results in a 55-point scale. The split-half reliability estimate was .89 (SEmeas = 2.25). The KR20 reliability estimate was .80 (SEmeas = 3.03). The mean item difficulty was .72. Gender differences were not significant.

In 1998 this scale was also converted with Java (TM) for administration on the Internet/WWW. The standard form uses the mouse with typical graphical user interface. The enabled form uses keyboard control with a larger font display. Sound files were created to present each item in the AU file format. In both forms, the individual responds by typing the numbers. Results are reported with the sten score derivation described above for the CogAttention scale.

CogMemory appears to directly tap the "sequential" function in the contemporary PASS theory. Tests of memory span for digits are often used in neuropsychological assessment with differential performance typically evident between normal and brain damaged persons (Lutey, 1977). Digit span also appears to differentiate between left and right brain damage; left brain lesions are associated with markedly lower scores (Kaufman, 1990).

Cognitive Style Test:

CogStyle is based on a model (Lowen, 1982) originally intended to facilitate computer modeling of personality traits. The four factors measured are: attitude (extraversion- introversion); approach (concrete-abstract); focus (people-things); and style (contextual-detailed). In addition to general utility, the CogStyle test is included in this context with growing evidence of a brain-behavior relationship associated with personality traits.

The four traits measured in CogStyle appear comparable to the dimensions in the Myers-Briggs Type Indicator (Myers & McCaulley, 1985). They are also, with the exception of omission of an anxiety scale, consistent with traits suggested by the so-called "big five" (Costa & McCrae, 1992) model of personality. Prediger, Swaney, and Mau (1993) suggest that the six vocational personality dimensions in Holland's premier model for vocational personality assessment (Holland, Fritzsche, & Powell, 1994) can be interpreted with a two-factor solution comparable to the approach and focus scales noted above.

CogStyle was developed with a goal to create an effective instrument for use by sighted persons and persons with visual disability. Item selection and tryout began with sighted samples with additional field testing then completed using two primary samples of high school students with visual disability and additional data from samples of adults with visual disability.

Development of the 35-item CogStyle started with a 56-item pretest using forced choice comparisons of adjectives, active verbs, occupations, and abilities associated with each of the six Holland dimensions. This pretest and a form of the Myers-Briggs Type Indicator (MBTI) were administered in the Spring of 1995 to 130 sighted subjects drawn from a community college and a university located in the western U.S. With MBTI scores as the primary criteria for item selection, 45 items were chosen for the second stage of field testing.

The new research instrument was then administered to a sample of adults with visual disability and to secondary school subjects drawn from two settings: a cohort of students with visual disability enrolled in a regular comprehensive high school and an additional group of students enrolled in a residential school for students with visual disability. These students completed the research instrument and Hollands's Self-Directed Search (Holland, Fritzsche, & Powell, 1994).

The 35 items which comprise CogStyle were selected using data from both sighted subjects and subjects with visual disability. In final form, one adjective and one action verb were selected to represent each of the Holland dimensions. Paired adjectives and then action verbs for each of the six dimensions are presented to the subject with instructions to choose the one which "fits you the best". There are thus 30 paired comparisons. Three additional items to enhance discrimination in the attitude (extroversion-introversion) and two additional items to enhance discrimination in the style (detailed-contextual) factors were selected. The scoring procedure combines formulae suggested by Prediger, Swaney, and Mau (1993) and an application of Bayesian scaling (Jones, 1989). Scores are on a scale of 1 to 100 and identified as either strong or mixed preference.

Data from the field studies suggest that CogStyle can be effectively used for general and vocational personality assessment with adolescents and adults from both the sighted population and those with visual disability. Both standard and enabled forms of CogStyle are available on the Internet/WWW.

There is growing evidence that core personality traits are associated with neuropsychological functions. Wilson and Languis (1989) found a relationship between introversion-extraversion and brain electrical activity patterns. In a scale comparable to CogStyle focus, Dunn, VanCleave, and Hymes (1984) found evidence suggesting a relationship with closure speed. With a different instrument a trait comparable to CogStyle focus is identified as corteria (Russell & Karol, 1994) and is associated with quick reaction time, high alpha wave interruption in EEG, and other physical signs of high cortical activation level. Jones (1998) found significant relationships between the focus scale and a variety of cognitive processing tasks.

Application:

Although both CogAttention and CogMemory appear to be close approximations of the original scales, there are many factors which may influence precision of measurement in the Internet/WWW format. The user is strongly encouraged to focus on the low-average-high interpretation, and it is especially important that these results not be used without additional confirmation for individual diagnosis and/or intervention planning. The tests are located at http://www.unlv.edu/Colleges/Education/EP/joneshom.htm. Use of the tests is free but password protected. For a password, send an e-mail with brief explanation of qualifications and intended use to jones@nevada.edu.

References:

Costa, P.T., Jr., & McCrae, R.R. (1992). NEO PI-R: Professional manual. Odessa, FL: Psychological Assessment Resources.

Dunn, B.R., VanCleave, R., & Hymes, D. (1984). The relation of the Myers-Briggs Type Indicator to closure speed. Journal of Psychological Type, 8, 45-47.

Golden, C.J., Purisch, A.D., & Hammeke, T.A. (1985). Manual for the Luria-Nebraska Neuropsychological Battery: Forms I and II. Los Angeles, CA: Western Psychological Services.

Holland, J.L, Fritzsche, B.A., & Powell, A.B. (1994). Technical Manual: Self-Directed Search, Odessa, FL: Psychological Assessment Resources.

Jones, W.P. (1980). Assessing basic competencies: visually impaired. International Journal of Rehabilitation Research, 3, 84-87.

Jones, W.P. (1989). A proposal for the use of Bayesian probabilities in neuropsychological assessment. Neuropsychology, 3, 17-22.

Jones, W.P. (1996). Career assessment for patients with visual disability: Consideration of instrument distortion. Journal of Vision Rehabilitation, 10, 2-7.

Jones, W. P. (1998). State-trait personality correlates: Neuropsychological assesssment lab report 1-2. [On-line] Available World Wide Web: http://www.unlv.edu/Colleges/Education/EP/Nl1-2.htm

Kaufman, A.S. (1990). Assessing adolescent and adult intelligence. Boston: Allyn & Bacon.

Lowen, W. (1982). Dichotomies of the mind: A systems science model of the mind and personality. New York: John Wiley.

Lutey, C.L. (1977). Individual intelligence testing: A manual and sourcebook (2nd Edition). Greeley, CO: Carol L.Lutey Publishing.

Myers, I.B., & McCaulley, M.H. (1985). Manual: A guide to development and use of the Myers-Briggs Type Indicator. Palo Alto: Consulting Psychologists Press

Naglieri, J.A., & Das, J.P. (1990). Planning, attention, simultaneous, and successive cognitive processes as a model for intelligence. Journal of Psychoeducational Assessment, 8, 303-337.

Prediger, D., Swaney, K., & Mau, W. (1993). Extending Holland's hexagon: Procedures, counseling applications, and research. Journal of Counseling & Development, 71, 422-428.

Russell, M.T., & Karol, D.L. (1994). The 16PF fifth edition Administrator's Manual. Champaign, IL: IPAT

Wilson, M.A., & Languis, M.L. (1989). Differences in brain electrical activity patterns between introverted and extraverted adults. Journal of Psychological Type, 18, 14-23.


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