MEMORY ASSESSMENT in the LAB vs. the CLINIC

• Laboratory goals:– Address theoretical questions about

memory forms and processes– Determine population mean & variance

• Clinical goals:– Detailed “case description”– Diagnosis (Organic? Malingerer?)– Prognosis for rehabilitation– Determining therapy– Assessing change in condition

• Types of Memory Tests:– Clinical need for standardized, normed– Experimental need for “special

purpose” tests

CRITERIA FOR CLINICAL TESTS

Standardized tests should be…

• Reliable• Valid• Sensitive• Sample wide range of..

– Retention intervals– Verbal , nonverbal– Simple and complex– Old memory and new learning– Quantitative and qualitative measures– “modes” of response

• Normed by age, IQ, etc• “Patient friendly”

– Quick and engaging

CLINICAL MEMORY BATTERIES

• Wechsler Memory Scale III (1997)– Orientation (How old are you? Who’s governor

of Florida?)

– Mental Control (recite the months of the year)

– Immediate Memory Span and Working memory (serial recall and sequencing of letters, digits, positions)

– Logical Memory (immediate and delayed recall of prose passages)

– Configural Memory (recognition of faces and family pictures, immediate and delayed)

• Wechsler Memory Scale III (1997)– Evaluation:

• Tests new learning only• Well normed, most popular test• Normed against WAIS (an IQ test)• Takes nearly an hour to administer• No alternative forms for assessing

change

WAISWMS Index FSIQ WM

Immediate Memory .57 .44

General Memory .60 .47

Working Memory .68 .82

% Y variance accounted for by X =r2(X,Y)

• Rivermead Everday Memory Test– Orientation (place, time and personal)– Verbal Recall (list of names)– Spatial Recall (set of hidden objects)– Spatial Route Recall (immediate and

delayed)– Immediate Recognition (of pictures and

faces)– Story Recall (immediate and delayed)– Prospective Memory (ask a specific

question when cue is given)

– Evaluation:• Tests new learning only• Good reliability and face validity• Four forms for assessing change• Takes less than 30 minutes to administer• Good “prognostic sensitivity”

• Baddeley Battery (!) for Verbal and Nonverbal Information– Peoples Test (photos, occupations, and

names of four people; cued recall)– Shapes Test (copy and later recall four

versions of abstract forms)– Names Test (recognition for 12 names,

4AFC (Matt Brownell, Mark Brownhill..)– Doors Test (recognition of 12 doors with

varied molding)

– Evaluation:• Tests new learning only• Good distinction between visual-spatial

and verbal materials• Quick and friendly• No delayed recognition• Limited norming so far

• Kopelman Memory Interviews– Personal Semantic Memory Schedule

(schools, friends, personal facts from various life periods)

– Autobiographical Incidents (cued recall of particular episodes from specific periods)

– Famous Personalities Test (Names and faces of famous and unknown persons by decade

– News Events Test (cued recall of details of pictured events by decade)

– Dead-or-Alive Test (!) (names of famous people by decade: dead or alive?)

– Evaluation:• Tests prior knowledge (retrograde)• Good range of retention intervals• Mostly verbal knowledge• Needs re-norming every few years• Difficulty of validating personal info

Factor Analysis of Clinical Memory Tests

• Hunkin, et al. (2000)– WMS-R and several other tests given to

50 patients with range of impairments– Assess correlations among scores, e.g.:

• WMS-Verbal with:

– WMS-Visual +.49

– WMS-Delay +.75

– WRMT-Words +.54

– WRMT-Faces +.16

– D&P doors +.30

– Derive independent factors for

• Immediate versus delayed• Recall versus recognition• Verbal versus visual for recognition, not

recall

• Summary of Clinical Batteries– Wide range of memory systems tested– Provides clinician with standard toolkit– Problem of ceiling and floor effects– Challenge of different norming groups– Complements ad hoc tests