Contemporary Approaches to Neuropsychological Assessment
This volume summarizes important developments in the practice of clinical neuropsychology during the past decade. Separate chapters review the Halstead-Reitan and Luria-Nebraska batteries, the two leading examples of “fixed” battery approaches to assessment (in which every patient receives the same set of tests); the rival “flexible” Boston Process approach is considered in a separate chapter. Other chapters describe neuropsychological findings and assessment methods for special populations (children, the elderly, psychiatric patients), improvements in norms for widely used tests, and completely computerized methods for neuropsychological assessment.
The volume has value for practicing clinical neuropsychologists because it brings together much recent research on assessment methods. For physicians, particularly psychiatrists, the book will be less useful. For example, the chapter on psychopathology and neuropsychological assessment contains accurate if brief reviews of research on schizophrenia, unipolar depression, and obsessive-compulsive disorder, but the authors do not propose assessment batteries for characterizing these patients. The chapter on assessment of the elderly contains an excellent discussion of assessment of severely demented patients but does not even mention the widely used test battery developed by the Consortium to Establish a Registry for Alzheimer's Disease. Surely, the assessment of mildly demented patients to identify specific patterns of impaired and spared cognitive functions is at least as important as quantifying deterioration in advanced cases. Another omission is the failure to consider special batteries that have been devised to assess cognitive functions in patients with a particular disease or condition (e.g., multiple sclerosis).
Considering that neuropsychological practice exists in an age of managed care, there is remarkably little concern anywhere in this volume for the possibility that one day soon compensable neuropsychological evaluation for all but forensic cases will be reduced to 2–3 hours of testing. Only the excellent chapter on computerized evaluation even raises the issue of efficiency of testing. The authors of this chapter make a strong case for the usefulness of computerized batteries, but they acknowledge that there are some functions (e.g., language) that cannot be assessed very well with computers.
In summary, this volume provides a good account of where neuropsychological assessment has been, but it is not very useful in pointing the direction for the future.
