Culturally Sensitive Neuropsychological Assessment Strategies

This report provides an overview of neuropsychological assessments in culturally and linguistically diverse (CALD) populations, highlighting the challenges and considerations necessary for accurate and unbiased evaluations. It addresses the potential for misdiagnosis and false positives due to cultural factors and the limitations of using Western-centric assessment tools. The report examines specific assessment tools like RUDAS and SMMSE, discussing their applicability and potential biases within CALD contexts. It emphasizes the importance of assessing acculturation levels and language proficiency to mitigate cultural and racial biases. Ultimately, the report advocates for the development of culturally sensitive and linguistically appropriate assessment methods to improve diagnostic accuracy and treatment outcomes for CALD individuals, particularly within the Australian context, where migration contributes to a highly diverse population. Desklib offers a range of similar documents and study resources for students.

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Neuropsychological assessment of people of a culturally and linguistically diverse
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Introduction
Providing cultural sensitive clinical service has been an essential component in the
delivery of neuropsychology among diverse people. Conducting a neuropsychology
assessment needs to focus on several areas while dealing with linguistically different and
diverse populations. Assessments play the crucial role in impacting on the general persons.
Assessment in neuropsychology refers to the collection and identification of risks and
diagnoses which are associated with psychology, which integrates relevant issues.
Comprehensive assessments often take multidimensional angles and interdisciplinary
approach.
The Diagnostic and Statistical Manual of Mental health Disorders, has put into focus
the need of incorporating culture in the diagnostic criteria of patients using this tools, a
diagnostic tool utilized has been added which s Neuro-Cognitive Disorders who has been
added. Two diagnoses have been added to this category. However, despite these
modifications, questions arise as to whether the neuropsychology parameters are effective in
testing cultural factors, (APA, 2013).
Research undertaken on neuropsychology assessment has shown that occurs
misdiagnosis and observation of false positive has been noted among people with diverse
cultural associations,(Norman et al., 2011). Norman et al showed that the application of
normative and clinical psychology impairment, memory and visual learning was higher
among healthy African-American people.
There has been an increasing demand for mental psychologist within the health services
on increase of assessing cognitive functions of culturally and Linguistically Diverse persons.
Most of the current research has been undertaken and has made comparisons of test factors
among CALD groups having western education and those having the Caucasian background.
Using standardization samples of the Weschler Adult Intelligence Scale-Third edition, the
African-American and Hispanic subjects showed to have scored lower than Caucasian
subjects, (Wechsler, 2008).
Controls undertaken for CALD in Australia showed that persons having CALD
background showed low performance compared to those under the Weschler Adult
Intelligence Scale. The cultural difference on the Wechsler scale has been undertaken among
patient groups and people with mixed neuropsychiatric disorders among other groups,
(Boone, Victor, Wen, Razani, & Ponton, 2007).
There have been observed diagnostic disparities on the use of neuropsychology

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practices. Sensitivity has been noted to be prevalence among various groups. Numerous
studies have reported the emergence of false positives errors while conducting the tests. This
has led to a lack of specificity with regard to neuropsychology measures and standard of care
for CALD persons.
Majority of the Cognitive assessments scales have been developed and focussed on
western countries culture, this has influenced the way it was designed. Usage of this
assessment on CALD has been shown to offer the wrong diagnosis.
Examples of assessment tools used
RUDAS
RUDA refers to Rowland University Dementia Assesment tool a tool developed by the
University of Rowland which assess cognitive impairment among people experiencing
impairment from various educational, cultural and linguistically different populations. Each
item under the tools has cultural relevance and ease of making translations easy.
The key potential benefits of RUDAS is that it seems to have less educational and
cultural background with regard to assessments and it takes less than 10 minutes to
administer. I entail a series of questions which are aimed at assessing the memory, praxis,
visuospatial and visuoconstructional memory. It has a cut-off score f 22 or less indicating
impairment, 23-30 showing normal neuropsychology state.
RUDAS has been found to be free from any cultural connotations and bias in
multicultural settings in Australia, however, one study in South India found an impact of
education on RUDAS score, (Storey, Rowland, Basci, Confortu &Dickson, 2004)
SMMSE
This refers to the standard mini-mental state examination tool which is used for CALD
people. SMMSE is an adaptable tool which assesses mental state and provides critical
assessments with regard to psychology state. It has a cut off points ranging 0-30 indicating
low scores, (Basic et al 2009).
Various issues have been highlighted with regard to psychology assessment. Usage of
standards’ tests with minority and culturally diverse groups has proven to be c challenging
task. Important factors which have been observed is that there is an occurrence of
overdiagnosis, segregation of persons and mistreatments. Culture has been a confounder in
undertaking neuropsychology assessments among different communities and also among the
communities who are not from the western origin.
Effects of acculturalization have always been felt on the individual performance of

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cognitive stets. Neuropsychological assessments have been shown not to be free from cultural
and racial biases which are common. While assessing neuropsychology, it is critical for
acculturation level to be ascertained as this obtains views from the examinee on the potential
factors which might affect assessment. Further factors affecting acculturation needs to be
assessed and gathered, (Hwang & Ting, 2008).
Assessment of language proficiency is an essential component in assessing
neuropsychology state. Language proficiency has been shown to affect many facets of
psychology assessment across the population. Through assessment on the use of language
plays an important role in assessing neuropsychology among CALD community,
(Mahendran, Chua, Feng, Kua & Preedy, 2015).
In Australia, cultural diversity plays a crucial role in the healthcare process. In
psychology arena, there is an increasing demand for assessment of cognitive function among
CALD persons. Research done has shown that conducting neuro assessment for CALD is
crucial. Existing research has focused on the comparison of test performance on different
CALD groups in Australia. Studies done on western educated and Caucasian blacks showed
different variations on the usage of different tools were used. Classifications using Wechsler
Adult Intelligence Scale-Third Edition (WAIS-III) and Wechsler Memory Scale showed
variations. African Americans were misclassified using a cut off SD below 1, (Weschler,
2008).
Controls of Australian origin had lower performance among English speaking
backgrounds using the WAIS-R tool on IQ and WAIS-R on picture completion subtest.
Further CALD person test on the first language scored low on WAIS-R. Cultural differences
have been observed using this tools and also with people having mixed neuropsychiatric
disorders, (Rosenberge, Dethier, Kessesls, Westbrook & McDonald, 2015).
A study to assess the cognitive function among different individuals has shown that
linguistically diverse groups of persons often experience challenges. An investigation on the
diverse cultural background using WAIS scale showed that English educated diverse group
performed dismally compared to English speaking diverse group while the no English
speaking diverse group performed very low across the groups being compared to, (Walker,
Batchellor, Shores & Jones, 2010). This result indicates divergent assessments are relevant in
assessing the CALD group. There extremely challenges in assessing their neuropsychology
status.
Conclusion

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The high population of divergent and different cultures has portrayed a significant
challenge in neuropsychology assessments. In Australia, there is a high rate of migration of
different people into the country having diverse backgrounds. There is a need for
comprehensive tools which addresses this group of persons and improves on outcomes of
treatment. In assessing larger community network, developing linguistically specified data is
of the essence. Development of a normative data with acceptable validity and reliability tests
is relevant among specific CALD grounds with respect to Australia. The study trials done
have concluded that usage of WAIS matrix is a relatively effective tool lacking culture
biases, however, in order to achieve this, assessment of English proficiency, and
socioeconomic status needs to be taken care of.

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