Ecological Validity and Naturalistic Assessment: Research Update and Clinical Applications

(3.0 CE Credits)

This course will provide a clinically relevant summary of the literature in two related constructs: Ecological Validity and Naturalistic Assessment. The first part of the course will be an overview of ecological validity and its role in clinical neuropsychology. Ecological validity is the degree of agreement between neuropsychological test performance and real world performance. Research regarding ecological validity, including current controversies and unanswered questions in the field, will be reviewed. The clinical implications of this literature will be explored via case vignettes of common clinical scenarios. Attendees will be given practical ways to translate research findings into routine clinical practice across clinical contexts. The second part of the course will explore naturalistic assessment, or the measurement of behavior in real-world environments. We will present a broad overview of current approaches to naturalistic assessment, including structured real world tasks, virtual reality, and smart home passive sensor systems. Research on how these naturalistic assessment tasks relate to traditional cognitive tests will be reviewed. We will highlight the ways in which this research has informed our understanding of functional limitations secondary to cognitive impairment within a variety of neurologic conditions. Case examples will be used to demonstrate the importance of collecting data in real-world environments to complement traditional neuropsychological assessment and inform recommendations.

After the presentation, participants will be able to:

1. Describe the differences between ecological validity and other forms of test validity.
2. Apply and use ecological validity research findings to help inform clinical neuropsychological practice.
3. Analyze and critique the utility ofnaturalistic assessment, as well as delineating the strengths and weaknesses of varying approaches. 

 

Presented by:
Naomi Chaytor, Ph.D.
Elson S. Floyd College of Medicine, Washington State University

Kayela Robertson, Ph.D.
VA Puget Sound Health Care System

 

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The Spectrum of Concussion: Recovery Time, Treatment, Rehabilitation, and Possible Long-Term Effects on Brain Health

(2.0 CE Credits)

Concussion has received enormous attention from the medical and scientific communities as well as extensive media coverage and public-policy interest. Although much has been learned, there remain critical unanswered questions relating to the clinical care, treatment, and ultimate wellbeing of student and professional athletes. This workshop will review the spectrum of concussion, from acute effects to possible long-term effects on brain health. Topics covered will include: (i) comorbidity factors that influence athletes’ trajectories of recovery from concussion; (ii) factors relating to fast and slow recoveries; (iii) improving assessment, treatment, and rehabilitation; (iv) examining possible long-term effects of multiple concussions on later-in-life brain health; and (v) a critical review of chronic traumatic encephalopathy.

After the presentation, participants will be able to:

1. Delineate anticipated recovery times for those who sustain a sport-related concussion.
2. List factors or characteristics associated with a slower recovery from concussion.
3. Develop and compile more personalized treatment and rehabilitation plans for those who are slow to recover.
4. Describe and critique what is known (and not known) about risks for long-term effects of multiple concussions, including accelerated aging, neurodegenerative diseases,  and chronic traumatic encephalopathy.

 

Presented by:
Grant L. Iverson, Ph.D.
Professor, Department of Physical Medicine & Rehabilitation, Harvard Medical School
MassGeneral Hospital for Children™ Sports Concussion Program 
Traumatic Brain Injury Program, Home Base, A Red Sox Foundation
Massachusetts General Hospital Program

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The Technology Crisis in Neuropsychology: How Did We Get Here and Where Do We Go Next?

(3 CE Credits)

Major advances in computer technology have been made over the past 30 years, enabling society to move firmly into the Digital Age. However, during this same time span, the vast majority of neuropsychologists, practicing in clinical and research settings, continue to utilize paper-and-pencil tests, many of which were developed more than 100 years ago. The goal of this workshop is to discuss neuropsychology’s current “technological crisis” and to provide a positive approach for moving the field into the future. The workshop will begin with a review of the origins of neuropsychological tests, technical factors that have hindered development of new tests, and provide survey results indicating how neuropsychologists appear to be hesitant to move ahead with computer technology. The second half will include a presentation of several proposed methods to integrate technology into cognitive assessment practices, and some of the potential benefits such integration would offer. Novel means of data capture, including use of modern psychometric theory, web-based and digital assessment tools, and potential applications of these methods will be discussed. With greater utilization of digital assessment methods, it is anticipated that there will be an exponential increase in the volume of available data for normative purposes, including data from multiple cultural and linguistic groups. Of critical importance throughout the transition to more technologically advanced assessment is creative development of new measures with more direct ties to neuroanatomical systems that think “outside the box” and break free from current conventions and restrictions imposed by our continued use of older technology.

After the presentation, participants will be able to:

  1. Analyze the professional, social, and economic factors underlying neuropsychologists’ apparent reluctance to adopt automated testing technology. 
  2. List the technological difficulties encountered when attempting to develop computerized test batteries. 
  3. Identify the key benefits of a collaborative knowledge base (KB) for aggregating cognitive data.
  4. Delineate two sources of data that will supply the KB.
  5. Describe one potential technique for generating new methods of assessment and maintaining an adaptive test repository.

Presented by:
William B. Barr, Ph.D.
NYU School of Medicine

Justin B. Miller, Ph.D.
Lou Ruvo Center for Brain Health

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Historical, Conceptual, and Empirical Factors in Performance and Symptom Validity Assessment

(3 CE Credits)

The accuracy of a neuropsychological evaluation is dependent upon both test validity and assessment validity. Assessment validity comprises both Performance (PVT) and Symptom (SVT) Validity Tests. PVTs inform as to whether the examinee is providing an accurate measure of their actual capabilities, while SVTs inform as to whether the examinee is providing an accurate description of their actual symptom experience. Failure to assess performance and symptom validity can distort expected clinical relationships, such as the association of duration of coma with degree of neuropsychological impairment. The history of PVT and SVT development will be reviewed, emphasizing clinically atypical patterns and levels of performance on these procedures, resulting in low false positive rates in cases with bona fide acquired neurologic and psychiatric disorders. Research designs for investigation of performance and symptom validity will be reviewed. Malingering will be defined and the base rate of PVT failure will be discussed, as well as the sensitivity and specificity of these procedures and the risk of false positive error with use of multiple PVTS.

After the presentation, participants will be able to:

  1. State the difference between performance and symptom validity tests (PVTs and SVTs).
  2. Describe the historical background of PVT and SVT development.
  3. Explain how PVT and SVT failure informs a diagnosis of malingering.
  4. Summarize the problem of false positive identification, and discuss how reliance on multiple PVTs and SVTs can improve diagnostic accuracy.

Presented by:
Glenn J. Larrabee, Ph.D.
Independent Practice of Psychology

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Managing Concussion: An Interdisciplinary Approach to the Care of Children and Adolescents with Sport/Recreational Concussion

(1.5 CE Credits)

The minority of athletes who have concussion symptoms lingering for weeks or months require involvement and treatment by an interdisciplinary team of health care providers to guide recovery.  This talk will review the types of treatments that can be offered to the slow-to-recover patient by the various members of the interdisciplinary team.  The main focus, however, will be how clinical or health psychologists can contribute to care by treating associated psychological disorders and guiding return to active learning, work, and recreational activities to optimize quality of life and enhance recovery.

After the presentation, participants will be able to:

  1. Discuss how a multi-disciplinary team of health care providers can facilitate recovery in those who are slow to recover.
  2. Describe how the evaluation and treatment of post-concussion syndrome differs from acute management of the injury.

Presented by:
Brenda J. Spiegler, PhD., C. Psych., ABPP (cn)
Director, Department of Psychology
Hospital for Sick Children
Associate Professor, Department of Pediatrics
University of Toronto Faculty of Medicine

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Psychological Factors Associated with Concussion

(1.5 CE Credits)

Empirical findings on pre-morbid and concurrent psychological factors that are associated with prolonged recovery will be reviewed.  This presentation will also address how the current focus on concussion dangers may have contributed to increased anxiety, and psychotherapeutic interventions will be discussed.

After the presentation, participants will be able to:

  1. Identify pre-existing and co-morbid psychological factors associated with prolonged concussion recovery.
  2. Describe misattributions and cognitive biases that may prolong concussion recovery.

Presented by:
Donna K. Broshek, Ph.D.
President, Sports Neuropsychology Society
Co-Director, Brain Injury & Sports Concussion Clinic
Director, Neurocognitive Section
Professor, Psychiatry & Neurobehavioral Sciences
University of Virginia Health System

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Understanding Sports-Related Concussion: Mechanism of Injury, Pathophysiology, Evaluation, and Symptom Expression

1.5 CE Credits

The mechanisms of injury that cause sports-related concussions and the pathophysiological underpinnings of the injury will be reviewed.  The dynamic relationship between symptom expression and underlying metabolic processes will be discussed.

After the presentation, participants will be able to:

  1. List the various ways concussions occur in the sports setting, and identify the observable signs of concussion.
  2. Explain the neurometabolic cascade that underlies concussion and the dynamic character of that cascade.

Presented by:
Ruben Echemendia, Ph.D.
Past President, Sports Neuropsychology Society
Fellow and Past President, National Academy of Neuropsychology
Fellow, American Psychological Association
Co-Chair, NHL Concussion Subcommittee
Chair, MLS Concussion Committee

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Understanding Autism Spectrum Disorders from a Neuropsychological Perspective 

(3 CE Credits)

As more interdisciplinary research has been conducted on autism in recent years, our view of this complex neurodevelopmental disorder has dramatically changed. This presentation will review the changes in diagnostic criteria that will be introduced in DSM-V and discuss the challenges of diagnosis at various developmental stages. Recent research on the underlying genetic and neurobiological causes of autism spectrum disorders will be reviewed, with an emphasis on how this affects our understanding of the behavioral phenotype in autism. The impact of early intervention will be discussed as well as the role of the pediatric neuropsychologist in working with children with autism spectrum disorders. 

Learning Objectives:
  • Explain changes to the diagnostic criteria for autism spectrum disorders that will be introduced in DSM-V.
  • Describe the need for early intervention in these children.
  • Describe recent research on the underlying genetic and neurobiological causes of autism spectrum disorders.
  • Apply knowledge gained from a review of the research to conceptualize the specific behavioral phenotype of autism spectrum disorders and be able to discuss the role of a pediatric neuropsychologist in the conceptualization, diagnosis, and treatment of autism spectrum disorders.

Presented by:
Natacha Akshoomoff, Ph.D.
University of California, San Diego

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An MMPI-2-RF Update for Neuropsychologists 

(3 CE Credits)

Five years after its release, the MMPI-2-RF is used widely in neuropsychological evaluations. Over 170 peer reviewed studies of the test have been published, many in neuropsychology journals. This workshop provides an update on the research base available to guide use of the instrument in a broad range of settings and types of assessments, including intake to chronic pain treatment programs, pre-surgical psychological screenings, clinical evaluations, and forensic examinations. The literature available to guide MMPI-2-RF interpretation in these settings will be reviewed first, followed by presentation of a series of case studies. In keeping with the theme of this year’s conference, new data on MMPI-2-RF findings across the adult life span will be presented.

Learning Objectives:

  • Identify, classify, and cite MMPI-2-RF research.
  • Utilize peer reviewed data to guide MMPI-2-RF interpretation.
  • Critically analyze the association between age and MMPI-2-RF scores when using the instrument.
Presented by:
Yossef S. Ben-Porath, Ph.D.
Kent State University

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Lifespan Issues in Moderate-Severe Traumatic Brain Injury

(3 CE Credits)

This presentation will review the most common causes, physiological and anatomical characteristics, and cognitive and psychosocial sequelae of complicated mild to severe traumatic brain injury at various points across the lifespan. Similarities and differences will be reviewed with respect to risk for, causation of, and manifestation of traumatic brain injury in children, young adults, and senior elderly. Advances in evidence-based diagnostic procedures and interventions will be described. Long-term outcome data with regard to injuries sustained earlier in life will also be discussed. Particular attention will be paid to predictors of various cognitive and psychosocial outcomes, and how demographic and psychological variables may either moderate or mediate such outcomes. Specific vulnerabilities of those at both of the extreme ends of the age spectrum to sequelae of complicated mild to severe injuries will be illustrated. 

Level: Advanced

Learning Objectives:
  • Discuss neuroimaging as relevant to moderate-severe traumatic brain injury (TBI). 
  • Analyze construct and criterion validity of psychometric tests in samples with TBI. 
  • Describe the differences between pediatric, adult, and geriatric TBI. 
  • Discuss long-term consequences of TBI sustained early in life.
Presented by:
Jacobus Donders, Ph.D.
Chief Psychologist, Mary Free Bed Rehabilitation Hospital

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