1. Wide Range Assessment of Memory and Learning Second Edition
David Sheslow, PhD
Wayne Adams, PhD

2. About the authors: Dr. David Sheslow
PhD in Clinical Psychology, University of North Carolina at Greensboro
29 years at the DuPont Hospital for Children as chief psychologist and co-director of the Division of Behavioral Health, Department of Pediatrics
Teaches at the DuPont Hospital Pediatric and Psychology Residency Programs
Private, Clinical Psychology practice
Published over 48 professional articles

3. About the authors: Dr. Wayne Adams
PhD in Developmental and Child Clinical Psychology from Syracuse University
23 years at DuPont Hospital for Children, Director of the Division of Psychology, Chief Psychologist within the Division of Behavioral Medicine
Associate Professor at Jefferson Medical College
Published >30 articles, >60 presentations at conventions of professional organizations
Diplomat status, Clinical Psychology, American Board of Professional Psychology
Currently a tenured professor and chairperson of the APA accredited Graduate Department of Clinical Psychology at George Fox University, Newberg, OR

4. About the authors:
Drs. Adams and Sheslow have co-authored 5 instruments. They have extensive experience working with children and teens with mild to severe neurological disorders such as Learning Disabilities, ADHD, and Traumatic Brain Injury. It is this clinical involvement that lead to the development of a memory battery when there was none normed on children.

5. Evaluation of Memory:
Our Clinical and
Empirical Roots

6. Historical Roots Hans Ebbinghaus (1850 – 1909)
Immediate memory (digit span)
Chunking
Nonsense syllables
Meaningfulness
Rehearsal
Interference
Disadvantage of age
Memory “illusions”

7. Historical Roots Alfred Binet (1857 – 1911) Qualitative analysis
Serial position effect
“Importance” effect
Acoustic vs. semantic recall effects
Frederic Barlett ( )
Visual and motor memory

8. Historical Roots Sigmund Freud Repressed memory effects
Theodule Ribot ( )
Encoding, storage, retrieval
Procedural and volitional memory
Study of amnesias
Developmental aspects of memory
Immediate memory improves during school years
Declining long-term retention with age

9. Historical Roots Associationism Function of habit strength
Simple association between external stimulus and observable response
Introduction of the Computer
People are active information processors
Memory is a “storage system” with stages

10. Historical Roots Broadbent (1958) “serial processing”
Atkinson and Shiffrin (1968)
Sensory register, short-term store, long-term store
Control processes
Craik and Lockhart (1972)
“levels of processing”

11. Historical Roots Developmental Aspects:
Immediate recall improves during school years
Improvement on immediate memory tasks is particularly noticeable until 13 years of age
Children’s performance across ages does differ
Long-term retention declines with increasing age
Gender differences are small or non-existent
Memory performance is related to IQ but the correlation is not very high

12. Historical Roots Neuropsychological Influences
H.M. (hippocampal lesion)
Intact short-term, severely impaired long-term
Support for multi-store model?
Non-localized dimension?
Executive processes

13. Contemporary Status Neuroimaging studies
Computational/connectionist models
Multi-system nature, active, dynamic
Interaction of:
Memory
Executive functions that control and regulate
Knowledge and skills of learner

14. A sampling of historical memory concepts found on WRAML2
Primacy/Recency
List Learning
Learning Trials and Learning Curve
Recognition Memory
Immediate vs. Delayed Recall
Sustained Attention
Working Memory
Gist vs. Verbatim
Verbal vs. Visual
Rote vs. Meaningful

15. Early Memory Measures Rey (list learning of 15 words) 1958
Rey-Osterrieth Complex Figure Task (1944)
Wechsler Memory Scale (1945)
Wechsler Memory Scale – Revised (1987)
Wechsler Memory Scale – III (1997)
Wide Range Assessment of Memory and
Learning (1990)

16. Test Revision
WRAML WRAML2
(1990) (2004)

17. Major Modifications WRAML to WRAML2
Upper age range extended from 17 to 90 years
Indexes better reflect factor structure: Verbal Memory, Visual Memory, Attention/Concentration
Number of Core Subtests (6 vs. 9)

18. Major Modifications WRAML to WRAML2
Delay Memory Tasks (7 vs. 4)
2 Working Memory
Recognition Memory (4 vs. 1)
Qualitative Analyses (25+ vs. 0)
Updated stimulus materials

19. Core Subtests Optional Subtests Qualitative Analyses
WRAML2 Structure
Core Subtests
Optional Subtests
Qualitative Analyses

20. Core Indexes and Subtests

21. Psychometric Properties of the WRAML2

22. Test Development Focus group meetings, research
Inclusion of working memory and recognition
Item tryout (n = 140)
Item Response Theory, Rasch analysis
Development of Standardization Edition

23. Standardization Stratified Sampling Using Age Gender Geographic Region
Education Level
Ethnicity
N=1,200, 80 for each of 15 age groups

24. Reliability: Core Subtests
r values
Person Separation
Item Separation
.99 – 1.0
Internal Consistency
.81 – 92
GMI = .93
Test-Retest
(median interval = 49 days)
GMI = .82 (=6.7 pts)
Subtest Interscorer Reliability = .98

25. Internal Validity Item separation = .98 to 1.00 Factor Analysis
Three-factor Core Model: Verbal Memory, Visual Memory, Attention/Concentration
Applies to all demographic groups
Working Memory – Attention/Concentration r = .99
Three-factor Optional Model: Working Memory, Verbal Recognition, Visual Recognition
Differential Item Functioning: most in high .90s, .88 on Story Memory between Hispanic and White

26. External Validity Wechsler Memory Scale-III Children’s Memory Scale
Test of Memory and Learning
California Verbal Learning Test-II
.60 (GMI w/ GMI)
.49 (GMI w/ GMI)
.69 (CMI w/GMI)
.68 (Trial 1-5 Index
w/ Verbal Learning)
WAIS-II
WISC-III
.67 (FSIQ w/ GMI)
.44 (FSIQ w/ GMI)
WRAT3
WJ-III
.11 to .60 (w/ GMI)

27. Pediatric Clinical Groups
WRAML2
Verbal MI Visual MI GMI
Reading Disordered
(n=24)
ADHD
(n=23)
LD/ADHD

29. Adult Clinical Groups in Manual
WRAML2 GMI
Alcohol Abuse
91.4
Parkinson Disease
98.6
Traumatic Brain Injury
82.0
Alzheimer’s Disease
79.1

30. Administration General Points: Clipboard Pronunciation Practice
Organize Forms
Administration Time:
Core Subtests: minutes

31. Age-Based Normative Scores
Scaled Scores - Subtests
Mean = 10, SD =3
Standard Scores - Indexes
Mean=100, SD =15
Percentiles - Indexes
Age Equivalents
5 – 16 years

32. Other Data Available Confidence Intervals Index Discrepancy Data
Statistical significance
Prevalence data
Scaled and/or Cut Scores for qualitative analyses
Qualitative Analyses (with quantitative support)
Age-based descriptive statistics and clinical base rates (prevalence) are provided
Computer scoring program available

33. Core Indexes and Subtests

34. Story Memory Subtest Core Subtest (1), Verbal Memory Index
Two Stories read to Participant
A & B = 5-8 years
B & C = 9 years and older
Immediate Recall Trial
Upper case scoring criteria = requires an exact response
Lower case scoring criteria = acceptable gist responses listed in manual

35. Story Memory Subtest Core Subtest (1), Verbal Memory Index
Tips:
Practice reading stories out loud
Use a pencil to point to each word as it is read
Note unusual gist responses so can score later
Transfer to Verbatim and Gist columns later

36. Story Memory Subtest Associated Optional Subtests and Qualitative Measures
Story Memory Delay Recall
Story Memory Retention
Individual Story Comparison
Verbatim and Gist Measures
Story Memory Delay Recognition

37. Verbal Learning Subtest Core Subtest (3), Verbal Memory Index
List-learning task
13 words, 8 years and younger
16 words, > 9 years
Common words
Four learning trials

38. Verbal Learning Subtest Core Subtest (3), Verbal Memory Index
Tips:
One second pause between words
Number repetition order IF have time
Write first letter of word in free space

39. Verbal Learning Subtest Associated Optional Subtests and Qualitative Measures
Verbal Learning Delay Recall
Trials 1 – 4
Verbal Learning Slope
Verbal Learning Retention
Verbal Learning Intrusion Errors
Verbal Learning Recognition
Semantic vs. Phonological Error analysis for Recognition

40. Design Memory Subtest Core Subtest (2), Visual Memory Index
5 Design Memory Cards
Design Memory Response Form
Copying – aid for judging accuracy
Young examinees
Any age with poor visual-motor skills
Drawing task
5 second exposure
10 second pause before drawing

41. Design Memory Subtest Core Subtest (2), Visual Memory Index
Tips:
Take back the pencil each time after drawing is complete
Hold the pencil to deter grabbing
Let clock run and note time vs. resetting
Scoring guidelines in manual
Associated Optional Subtest:
Design Memory Recognition

42. Picture Memory Subtest Core Subtest (4), Visual Memory Index
4 Memory Stimulus Cards
Picture Memory Response Form
Red China Marker
10 second exposure
“Put an X on each part of the picture that has been changed, moved or added.”
Correct Zoo card only

43. Picture Memory Subtest Core Subtest (4), Visual Memory Index
Tips:
Put Memory Stimulus Cards in order
Can use a crayon – liquid markers typically bleed
Familiarize yourself with the Zoo responses, in particular, so can quickly correct if needed
Associated Optional Subtest/Qualitative Measure:
Commission Errors
Picture Memory Recognition

44. Finger Windows Subtest Core Subtest (7), Attention/Concentration Index
Finger Windows Card
Start places determined by age
5-8 years = A
9 years & older = 4
1 second in window, 1 second between windows
Correct A, B, and C only
If 4 is incorrect, go to A

45. Finger Windows Subtest Core Subtest (7), Attention/Concentration Index
Tips:
May be easier to write numbers in order while looking at card
Can place pencil on table between windows to aid timing

46. Number Letter Subtest Core Subtest (9), Attention/Concentration Index
1 per second
Examinee repeats the sequence in the same order

48. Verbal Working Memory Optional Subtest (14), Working Memory Subtests
Only administer to 9 and older
9 to 13 years = Level A and B
14 to adult = Level B and C
A: Repeat animals first, then non-animals
B: Repeat animals small to large first, then non-animals
C: Repeat animals small to large first, then non-animals small to large

49. Verbal Working Memory Optional Subtest (14), Working Memory Subtests
Example: Level B, Item B-6
Examiner: nail, elephant, lake, crab, kangaroo
Participant: crab, kangaroo, elephant, nail, lake
Scoring: 1 for animal grouping, 1 for non-animal grouping, bonus of 1 if both groupings are correct – intrusions are not accepted
Can teach on items A-1, A-2, A-3, B-1 but score first response

50. Verbal Working Memory Optional Subtest (14), Working Memory Subtests
Tips:
Directions are lengthy and wordy so must practice frequently before administering to ensure correct pronunciation. Use inflection to aid understanding.
If size dimensions are questioned (i.e. nose to scissors) say, “Think of the most usual size.”

51. Symbolic Working Memory Optional Subtest (16), Working Memory Subtests
Administered to 9 years and older only
Auditory input, non-verbal response
2 Levels
A: Numbers in order
Number Stimulus Card
B: Numbers order, then letters in order
Number-Alphabet Stimulus Card
Training items for each level

52. Symbolic Working Memory Optional Subtest (16), Working Memory Subtests
Tips:
Stress “numerical” and “alphabetical” order when reading directions
Remove or flip card after every item response
Subjects often point very quickly so may want to remember visually or write series on paper while watching

53. Optional Subtest (13), Additional Subtests
Sound Symbol
Optional Subtest (13), Additional Subtests
5 – 8 years only
Phonemes paired with visual symbols
Sound Symbol Booklet
Learning Trial
4 Test Trials (I to IV)
Provide positive feedback or correct responses on the first 3 Test Trials
If no response in 5 seconds, provide response and flip or just flip if Trial IV

54. Sound Symbol Associated Optional Subtest and Qualitative Measures
Sound Symbol Delay Recall
Trial 1 – 4
Sound Symbol Retention
Sound Symbol Slope

55. Sentence Memory Optional Subtest (15), Additional Subtests
8 and younger = Begin with Item 1
9 to adult = Begin with Item 8 (go back if necessary)
Say each sentence once only
2 points = 0 error
1 point = 1 error
0 point = 2 errors or more
Can teach #1 until they understand but score first attempt

56. Sentence Memory Optional Subtest (15), Additional Subtests
Scoring:
Response must be verbatim
Additions, omissions, changing word form, and contracting are one error
Tips:
Place pencil on each word to decrease error
Record incorrect response for scoring and analysis

57. Verbal Learning Recall Story Memory Recognition
Optional Subtests
Delay Recall Subtests
Recognition Subtests
Story Memory Recall
Verbal Learning Recall
Sound Symbol Recall
Story Memory Recognition
Design Recognition
Picture Memory Recog.
Verbal Learning Recog.

58. Story Memory Delay Recall Optional Subtest (5), Delay Recall Subtests
Return to Story Memory (1) scoring pages
Administer same story set as Story Memory
Do not read story to examinee
Indicate performance in the Delay Recall column
No Verbatim or Gist columns for delay but must comply with same scoring guidelines

59. Verbal Learning Delay Recall Optional Subtest (8), Delay Recall Subtests
Return to Verbal Learning (3) scoring pages
Do not read the list to the examinee

60. Sound Symbol Delay Recall Optional Subtest (17), Delay Recall Subtests
Return to Sound Symbol (13) scoring pages
Sound Symbol Booklet
Do not name any symbols
Delay Recall Trial is the same set as the Learning Trial

61. Story Memory Recognition Optional Subtest (6), Recognition Subtests
Administer same story set as Story Memory
Give automatic credit for any correct detail given during Story Memory Recall

62. Design Memory Recognition Optional Subtest (10), Recognition Subtests
Design Memory Recognition Booklet
Pencil or Marker
Review directions until examinee independently understands
Make sure page is correctly oriented
Do not let examinee go back once a page is finished

63. Picture Memory Recognition Optional Subtest (11), Recognition Subtests
Picture Memory Recognition Booklet
Pencil or Marker
Review directions until examinee independently understands
Do not let examinee go back once a page is finished
Can clarify that picture can appear on either the Picture Stimulus Card (cards with scenes) or Picture Memory Response Form (marked changes)

64. Verbal Learning Recognition Optional Subtest (12), Recognition Subtests
Administer if Verbal Learning and Verbal Learning Delay Recall have been administered
Ask for recognition of each word on list
Optional Qualitative Analysis
Semantic Error Total
Phonological Error Total

65. WRAML2 Screening Form 1st Four Core Subtests Story Memory
Design Memory
Verbal Learning
Picture Memory
Administration Time: minutes
Memory Screening Index and General Memory Index correlation = .91

66. Scores Raw – Scaled – Sum of Scaled – Index Graphic Representation
Index Score Discrepancy Analyses
Core Subtest vs. Recognition Discrepancy
Retention: Subtest minus Recall raw score

67. Qualitative Analyses - Scores
Story Memory
Individual Story/Verbatim and Gist Scale Score
Picture Memory
Commission Errors - Descriptive
Verbal Learning
Trials/Slope/Intrusion Errors – Graph and Descriptive
Verbal Learning Recognition
Semantic and Phonological Errors - Descriptive
Sound Symbol
Trials/Slope/Retention – Graph and Descriptive

68. Qualitative Analyses - Possible Implications
Story Memory
Forgetting “chunks” - Limited sustained attention
Delay better than recall - Need for memory consolidation
Reliance on Gist related to Reading Disability
Poor Delay Recall common in dementia or left temporal lobe head injury or stroke
Retention is particularly poor with moderate to severe brain injury, although immediate recall can be intact

69. Qualitative Analyses - Possible Implications
Verbal Learning
Flat curve could suggest adequate auditory memory but difficulty recalling rote information
Slight curve suggests subject may benefit from repetitive review
Variable curve could suggest attention/organization issues
Poor slope suggests limited or decreased learning; adequate slope suggests learning efficiency

70. Qualitative Analyses - Possible Implications
Verbal Learning, continued
Retention score < the 5th percentile could suggest recent brain injury or progressive dementia
Frequent intrusion errors may suggest limited self-monitoring, difficulty using feedback to change performance, disorganized processing, or confusion
Poor recognition may be associated with congenital developmental delay or neurologically based illness or injury

71. Qualitative Analyses - Possible Implications
Picture Memory
Low Recognition and adequate Memory (rare) could suggest developmental delay, neurologically-based illness or injury, fatigue, poor motivation/attention, or malingering
Poor Memory and adequate Recognition may suggest early-to-mid-stage Alzheimer’s
High Commission Errors may be associated with poorly modulated work style, disinhibition, and poor impulse control as often seen in AD/HD, TBI, and mania

72. Qualitative Analyses - Possible Implications
Sound Symbol
Retention score < the 5th percentile may suggest memory loss typical of phonologically-based reading disability, recent brain injury, or recent seizure disorder
Phonological/visual associates (tabe, wah, haa) are similar to the decoding aspects of reading