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 WAIS WMS 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