6/18/2012
Cognitive Screening / Assessment
and its Role in Understanding
Complexity
Jamie Berry
Senior Clinical Neuropsychologist
Director, Advanced Neuropsychological Treatment Services
(ANTS)
A presentation for the
NADA Practice Enhancement Forum
21st June 2012
Direct Effects
Behaviour
Cognition
Indirect Effects
Emotion
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6/18/2012
Pulmonary Disease
Heart Disease
High blood pressure
Diabetes
Substance Related Brain
Injury
Hypoxic Brain Injury
Stroke
Brain Infection
Traumatic Brain Injury
Mental Illness
Autism / Aspergers
Intellectual Disability
Learning Disability
ADHD
Dementia
Neuropsychological Assessment
• Typically takes 3-4 hours
– 1 hour interview
– 2-3 hours testing
– Uses standardised tests that can only be
administered and interpreted by an appropriately
qualified professional
– Outcome: diagnosis, prognosis and treatment plan
/ recommendations
Cognitive Screening Questionnaires
• Can be incorporated into intake or routine
assessment processes
• Can be completed in the absence of a worker
(e.g., whilst in the waiting room).
• Are naturalistic in their administration and
therefore reduce anxiety that is often
associated with ‘being tested’
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Cognitive Screening Questionnaires
• Neuropsychological Assessment Need Tool
(NANT)
– 6 domains and 31 items (Yes/No)
– Example items:
• “Have you ever been struck on the head and lost
consciousness?”
• “Do you experience memory problems?”
• “Have you experienced a change in personality?”
– Free online version
• www.neurotreatment.com.au/neuropsychologicalassessment-need-tool.aspx
Cognitive Screening Questionnaires
• Cognitive Failures Questionnaire (CFQ)
– 25 items, each rated on a 5-point scale
– Example items:
• “Do you read something and find that you haven’t been
thinking about it and must read it again?”
• “Do you fail to listen to people’s names when you are
meeting them?”
• “Do you fail to see what you want in a supermarket
although its there?”
– http://www.yorku.ca/rokada/psyctest/cogfail.pdf
Cognitive Screening Tests
• Provide a more objective measure of actual
cognitive abilities
• Essentially a highly abbreviated form of formal
cognitive testing (3 hours distilled into 10-20
minutes!)
• Cannot be used for diagnosis, prognosis or
generation of a specific treatment plan
• Screening tests are designed to be administered
by a large range of professionals / workers
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Cognitive Screening Tests
• Addenbrooke’s Cognitive Examination-Revised
(ACE-R)
– 18 subtests across 5 domains
– Total Score out of 100
– 15-20 minutes to administer
– Free online
• http://www.dementiaassessment.com.au/frontotemporal/ACER_A_AUS_version.pdf
Cognitive Screening Tests
• Montreal Cognitive Assessment (MoCA)
– 13 subtests across 8 domains
– Total score out of 30
– 10-15 minutes to administer
– Free online
• www.mocatest.org
START
Administer Cognitive
Screening Questionnaire
If positive result
If negative result
Administer Cognitive
Screening Test
If positive result
Refer for
neuropsychological
assessment for
opinion regarding
diagnosis, prognosis
and full treatment /
management
recommendations
If negative result
No
further
action
No
further
action
Use limited
information from
cognitive screen to
assist with
management of
cognitive
impairment
(preferably in consultation
with neuropsychologist)
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6/18/2012
Source: http://leftbankmanc.blogspot.com.au/2010/09/sexy-homeless-man.html
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