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Alan S. Kaufman Nadeen L. Kaufman Yale University School of Medicine

Intelligent Testing', theories of intelligence and intelligence tests, and neuropsychological diagnosis with special focus on the KAIT and the K-SNAP'

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Intelligent Testing Philosophy

The first step: Use the best tests available, focusing on psychometric properties (norms, reliability, construct validity), clinical utility, and theoretical rationale The clinician is just as important a tool as a high-quality psychometric instrument But even the best clinician and most "intelligent tester" cannot overcome a weak instrument, an invalid test administration, or scoring errors

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Intelligent Testing Philosophy

Profile interpretation requires detective work--the integration of background information and clinical observations with the person's profile of scores Test interpretation is like conducting a research study with N = 1

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Intelligent Testing Philosophy

Clinical tests of intelligence are administered individually--they must also be interpreted individually Numerous cognitive, developmental, and neuropsychological theories can be invaluable for understanding test profile fluctuations

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Historical Influences on Test Interpretation--1905-1950

1905 Binet-Simon develop 1st IQ test 19161937 Stanford-Binet--Only a Global IQ (Quinn McNemar)

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Historical Influences on Test Interpretation--1905-1950 1939 David Wechsler--Clinician; Wechsler-Bellevue; g theorist; Influenced by Pearson, Spearman, A. A. Brill, & others; Visionary David Rapaport--Psychodynamic approach to interpretation

1945

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Psychodynamic Interpretations of Wechsler Profiles

Rapaport, Gill, & Schaefer, 1945-46

Misses easy Comprehension items =

schizophrenia or psychotic depression

Adequate Comprehension with low Information = Hysteric Reaction High Picture Completion = possible

Paranoid trend

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Psychodynamic Interpretations of Wechsler Profiles

Allison, Blatt & Zimet (1968) carried Rapaport's ideas to an extreme:

High Digit Symbol with Low Digit Span suggests a person "who

seems to be controlling strong and pressing anxiety by excessive activity . . ."

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Psychodynamic Interpretations of Wechsler Profiles

"When we find the reverse pattern, a High Digit Span and a low Digit Symbol, we are usually confronted with an essentially depressed person who is attempting to ward off recognition of depressive affect perhaps in a hypomanic way, usually via denial."

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Psychodynamic Interpretations of Wechsler Profiles

"An 8-10 point difference between V and P IQs . . . indicates only a highly verbal subject with possible obsessive-compulsive tendencies. When V-IQ begins to have a marked imbalance over PIQ (by > 15 points), more serious pathological trends may be considered."

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Psychodynamic Interpretations of Wechsler Profiles

"P-IQ > V-IQ in individuals of at least average intelligence is atypical. Three major diagnostic trends, all of which have acting out as a primary feature, are suggested by such a pattern: Hysteric, Narcissicistic, & Psychopathic character disorders."

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Historical Influences on Test Interpretation--1951-1965

1952 Jacob Cohen--Factor Analysis of Wechsler's Scales 1955 Ralph Reitan--Emergence of Neuropsychology 1963 Samuel Kirk--Learning Disabilities Movement

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Historical Influences on Test Interpretation--1966-1980 1967 Glasser & Zimmerman--Clinical Interpretation of the WISC (& Alcorn/ Nicholson, 1974, on remediation) 1979 Alan Kaufman--Intelligent Testing with the WISC-R (& "Normal Scatter")

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Historical Influences on Test Interpretation--1981-1989

1983 Alan & Nadeen Kaufman--Shift from CONTENT to PROCESS (K-ABC) & develop an intelligence test from THEORY, most notably LURIA'S CLINICALLY-BASED neuropsychological theory 1989 John Horn & Richard Woodcock (WJ-R)-- Develop and intelligence test from THEORY, most notably HORN'S PSYCHOMETRICALLY- BASED cognitive theory

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Historical Influences on Test Interpretation--1990-2000

1990 Paul McDermott & Joe Glutting--The Malpractice of profile interpretation, especially Kaufman's "Intelligent Testing" Approach

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Historical Influences on Test Interpretation--1990-2000

1997 Jack Naglieri & J. P. Das--Expand Luria theory from Sequential-Simultaneous processing to PASS theory, emphasizing all 3 BLOCKS or Functional Units P = Planning A = Attention S = Simultaneous S = Successive (or Sequential)

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Historical Influences on Test Interpretation--2001-2004

Revisions of cognitive ability tests are published in the new Millennium Woodcock-Johnson III (2001)--Based on Cattell-Horn-Carroll (CHC) Theory WISC-IV (2003)--Not theory-based, but 4 Indexes conform to CHC theory Binet-V (2003)--Based on CHC theory KABC-II (2004)--Based on both CHC & Luria theories 17

Historical Influences on Test Interpretation--2004-2006

Development of Dutch K-SNAP and German K-NEK, based on Luria's 3-Block neuropsychological theory Development of Dutch KAIT and German KTIM, based on CHC theory, especially the original Cattell-Horn distinction between Fluid Intelligence (Gf) and Crystallized Intelligence (Gc)

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CHC Theory Applied to KAIT

Stratum III: General Ability is measured by the KAIT Composite IQ Stratum II: Broad Abilities Gray abilities are measured by KAIT Scales & subtests Stratum I: Narrow Abilities Blue abilities are measured by KAIT subtests

Associative Memory Memory Span Visual Memory Induction Lexical Knowledge Glr Long-Term Storage & Retrieval Gsm ShortTerm Memory Gv Visual Processing Gf Fluid Reasoning Gc Crystallized Ability

g

Learning Abilities

Working Memory

Spatial Relations

General Sequential Reasoning

General Information

Meaningful Memory

Visualization

Quantitative Reasoning

Language Development

Ideational Fluency

Spatial Scanning

Listening Listening Ability Ability Information Information about culture About Culture

Originality/ Creativity

Closure Speed

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CHC Theory--Fluid Reasoning (Gf)

Solving novel problems by using reasoning abilities such as induction and deduction.

Measured on KAIT by Fluid Scale, most notably by Mystery Codes and Logical Steps

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Fluid subtest: Geheime Codes

De proefleider presenteert een aantal figuren en de daarbij behorende codes. Met behulp van deze figuren en codes moet de cliënt een code voor een nieuwe figuur vinden.

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Fluid subtest Logisch Redeneren

De proefleider biedt de cliënt één of meer feiten aan, zowel auditief als visueel. De cliënt moet deze feiten logisch combineren om tot het antwoord te komen.

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Fluid subtest Geheugen voor Blokpatronen

De proefleider toont de cliënt gedurende 5 seconden een afbeelding van een blokpatroon. De cliënt legt dit patroon uit het hoofd na met behulp van zes blokken.

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CHC Theory--Crystallized Ability (Gc)

Demonstrating the breadth and depth of knowledge acquired from one's culture. Measured on KAIT by Crystallized Scale, most notably by Definitions and Famous Faces

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Crystallized subtest Definities

een donkere kleur een donkere kleur __ __ U II_ __ __ U _ De pl. laat twee aanwijzingen zien, waarmee de cliënt een bepaald woord moet vinden: 1. een omschrijving. 2. het woord, waarbij een aantal letters is weggelaten. De omschrijving wordt door de proefleider hardop gelezen.

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Crystallized subtest Persoonlijkheden

De proefleider toont foto's van beroemde personen en leest bij iedere foto een aanwijzing over de persoon voor. De cliënt moet de naam van de personen noemen.

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Crystallized subtest Dubbele Betekenissen

IDOOL IDOOL FILM FILM

De proefleider laat twee woordparen zien. De cliënt moet een woord vinden dat twee betekenissen heeft. Deze twee betekenissen zijn nauw gerelateerd aan de beide woordparen.

MAAN MAAN HEMEL HEMEL

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CHC Theory--Long-Term Retrieval (Glr)

Storing and efficiently retrieving newly-learned or previously learned information. Measured on KAIT by Rebus Learning, Auditory Comprehension, Rebus Delayed Recall, and Auditory Delayed Recall

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Fluid subtest Symbolen Leren

De proefleider leert de cliënt de betekenis van een aantal symbolen. De cliënt moet vervolgens zinnen of zinsdelen lezen, die uit deze symbolen bestaan.

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Afbeelding 1.8: Voorbeeld uit de subest Symbolen Leren.

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Crystallized subtest Auditief Begrip

Zo meteen laat ik u een opname van een korte krantenkop horen. Zo meteen laat ik u een opname van een korte krantenkop horen. Luister goed, want ik ga u er een vraag over stellen. Luister goed, want ik ga u er een vraag over stellen. (de proefleider zet de cassettespeler aan) (de proefleider zet de cassettespeler aan) Het belangrijkste nieuws van vandaag is: De minister heeft een Het belangrijkste nieuws van vandaag is: De minister heeft een nieuwe onderwijswet ondertekend. nieuwe onderwijswet ondertekend.

(de proefleider zet de cassettespeler uit). (de proefleider zet de cassettespeler uit).

De proefleider laat een bandopname van een nieuwsbericht horen en stelt na afloop vragen over dit bericht. De cliënt moet mondeling antwoorden.

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Cattell-Horn-Carroll (CHC) Broad Abilities Not Emphasized in KAIT

Auditory Processing (Ga) (but still important for Auditory Comprehension) Processing Speed (Gs) (but still important for Mystery Codes) Reaction Time/Decision Speed (Gt)

Not Sufficiently Complex

Achievement

Reading & Writing (Grw) (but still important for Definitions) Quantitative Ability (Gq)

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Luria Three-Block Theory

Block 3 Plans & Organizes Behavior

Block 2 Codes & Stores Information

Block 1 Maintains Attention

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Block 1--Maintains Arousal

Mediates attention and concentration. Allows focus of attention. Regulates energy level and tone of cerebral cortex. Recognizes significance of incoming stimuli. Allows receiving and processing of information.

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Block 2--Codes & Stores Information

Establishes connections with Block 3. Integrates incoming sensory information. Analyzes, codes, and stores incoming information via the senses. Uses successive and simultaneous processing.

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Block 3--Plans & Organizes Behavior

Involves decision making, generating hypotheses, planning, self-monitoring, and programming. Concerned with overall efficiency of brain functions, and is involved in all complex behavior. Though not directly involved with motor or speech functions, it represents the output or response center of the brain.

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K-SNAP

Luria Perspective (3 Blocks)

Block 1--AROUSAL (Mental Status) Block 2--CODING & STORAGE/INFORMATION PROCESSING (Number Recall & Gestalt Closure) Block 3--PLANNING/FRONTAL LOBE FUNCTIONS (Four-Letter Words)

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K-SNAP--Luria Block 1

In what year were you born? What city (or town, or village) are we in right now? Here is a quarter, here is a nickel, here is a dime, here are some pennies. How much money is here? Point to PUSH (the person is shown 6 doors, each with a different word on it) What day of the week is it today?

Mental Status Sample Items ATTENTION/AROUSAL

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OPEN

CLOSED

IN

A

B

C

PUSH

PULL

OUT

D

E

F

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K-SNAP--Luria Block 2

Gestalt Closure Sample Item SIMULTANEOUS PROCESSING

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K-SNAP--Luria Block 2

I am going to say some numbers. Try and say them just the way I do. 4-8 2-5-10 3-8-4-2 10-3-6-8-4 4-2-6-9-3-5 1-9-2-5-6-10-3

Number Recall Sample Items SEQUENTIAL PROCESSING

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K-SNAP--Luria Block 3

HEER HEER KEER KEER HIER HIER HARK HARK (2) (2) (2) (2) (1) (1) (0) (0) A A H H K K E E R R

__ __

Four-Letter Words Sample Item PLANNING ABILITY

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K-SNAP Four Letter Words

TAST MAST BONT KAAS A B (2) (1) (1) (0) _ E M O T

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K-SNAP Four Letter Words

NEEM ZAAG KERF WAAS WALS KAAS B E (0) (2) (0) (2) (1) (2) A

_ T O M

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K-SNAP Four Letter Words

PELT PLAT LEEG (2) (1) (3) ROOK GRAS KRAS (0) (0) (0) _ _

RA AS

OP KA

PA MA

AL EL

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KAIT Fluid Scale

Luria Perspective (3 Blocks) PLANNING ABILITY

Measures the high-level, executive functioning processes associated with Block 3, such as decision making, planning, organizing, generating hypotheses, & self-monitoring, (Frontal Lobe functions)

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KAIT Memory for Block Designs

Luria Perspective (3 Blocks)

SIMULTANEOUS PROCESSING

Synthesizing stimuli simultaneously (holistically), usually spatially, to produce the appropriate solution Requires the Coding functions of Block 2 (Simultaneous processing & Storage) & the Planning functions of Block 3 (working memory and strategy generation) 64

Crystallized Scale, Rebus Learning, Auditory Comprehension, and the two Supplementary Delayed Recall Subtests

Luria Perspective (3 Blocks)

The ability to learn and remember NEW and OLD information represents the integration of the processes associated with all three functional units, placing a premium on: Block 1 (Attention) and Block 2 (Coding, Storage, & Sensory Integration)

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