bluuebunny/crossref_metadata_2025_split huggingface dataset:
H - 51 Neuropsychological Evaluation of Non-Fluent English Speakers: a Case Study
Authors: Diaz Gisel , Ory Justin H 
Published: October 2023

Abstract

Objective
Sometimes patients are referred for neuropsychological evaluation who do not speak English as their first language. In many cases, we have declined evaluating patients who were not fluent in English, and when we have evaluated bilingual patients, have qualified the limitations of our interpretations. However, there are no neuropsychologists providing services in languages besides English in the state of Oklahoma, and most patients never received services.

Method
Patient is 83-year-old woman with five years of progressive decline in memory, unable to manage instrumental activities of daily living, presenting with family history of Alzheimer’s disease, and neuroimaging negative for atrophy or cerebrovascular disease. Patient was not fluent in English. Efforts to find a neuropsychologist able to evaluate in Spanish were unsuccessful, so testing was modified, and measures were administered by a bilingual psychometrist.

Results
Attention, orientation, and memory were impaired (MMSE = 14). Verbal fluency was intact in Spanish. Auditory memory was not assessed due to unavailability of Spanish measures. Visual memory was impaired, consistent with figure copy. WAIS-IV was administered in English, with instructions in Spanish.

Conclusions
Patient was diagnosed with possible Alzheimer’s disease. Recommended PET scan or spinal tap for Alzheimer’s disease biomarkers and reevaluation in Spanish in one year. Since neuropsychological evaluation is not available in every language, evaluation in English and highlighting the limitations of our findings may meet the ethical principle of beneficence, if we consider the impact of language and additional sources of data, such as collateral report of the patient’s caregivers, and medical tests.
H - 53 Performance Validity in a Mexican Population
Authors: Lopez Hernandez Daniel W , Sivaramakrishnan Krithika , Smith Krissy E , Munoz Isabel 
Published: October 2023

Abstract

Objective
The aim of the present study was to cross-validate recent research on three embedded performance validity tests (PVTs) in a Spanish-speaking Mexican sample.

Method
The sample consisted of 52 male and 77 female participants residing in Mexico with a mean age of 25.26 (SD = 10.45). Participants were neurologically and psychologically healthy and completed a neuropsychological battery in Spanish. The Reliable Digit Span, Phonemic Fluency Test (i.e., FAS), and Semantic Fluency Tests were used to evaluate failure rates in our sample. Daugherty and colleagues’ (2022) PVT cutoff scores were used. Chi-square analysis was used to evaluate failure rates between the groups.

Results
Chi-square analysis revealed no significant failure rate differences between gender groups on any PVTs. However, we found that 12% of the male group failed the Phonemic Fluency Test compared to 5% of the female group, X2 = 1.747, p = 0.186. Meanwhile, 2% of the male group failed the Semantic Fluency Test compared to 0% of the female group, X2 = 1.492, p = 0.222. Finally, 6% of the male group failed the Reliable Digit Span compared to 17% of the female group, X2 = 3.529, p = 0.060.

Conclusions
Our data shows that male participants demonstrate higher failure rates on verbal fluency tasks than females. Moreover, males had lower failure rates compared to females on Reliable Digit Span. Further exploration with bigger sample sizes is needed to explore what may be influencing validity test performance between gender groups. More studies in this area will help researchers and clinicians determine if persons completing cognitive tasks in Spanish are proving adequate effort.
H - 54 Effects of Acculturation in Neuropsychological Performance of Generation Z Mexicans
Authors: Lopez Hernandez Daniel W 
Published: October 2023

Abstract

Objective
We examined the influence of acculturation on Generation Z (i.e., persons born between 1997–2004) adults’ cognition.

Methods
The sample consisted of 15 low-acculturated, 47 moderately-acculturated, and 28 high-acculturated Mexican participants residing in Mexico with a mean age of 20.86 (SD = 1.63). All participants completed the Word Accentuation Test, all the subtests of the Stroop Color Word Test (SCWT), Boston Naming Test, Phonemic Fluency Test (i.e., FAS), Semantic Fluency Test, the copy and long-delayed Rey–Osterrieth Complex Figure (ROCF) tasks, all the subtests of the Digit Span, and the Abbreviated Multidimensional Acculturation Scale (AMAS) in Spanish. The AMAS was used to categorize acculturation groups. ANOVA’s were used to evaluate neuropsychological performance between our acculturation groups.

Results
We found the low-acculturation and moderately acculturation groups outperformed the high-acculturation group on the SCWT reading and color-word tasks, p’s &lt; 0.05, np’s2 = 0.09–0.10. Results also revealed the high-acculturation group outperformed the low-acculturation and moderately acculturation groups on the Semantic Fluency Test, p = 0.002, np2 = 0.14. Finally, the low-acculturation group outperformed the high-acculturation group on the ROCF copy task, p = 0.042, np2 = 0.07.

Conclusions
Our data suggests that Generation Z Mexicans’ level of acculturation influences their cognition. A possible explanation can be time perspective, where perception of time is influencing cognition to select and pursue certain goals, cognition, and motivation. Future studies using larger sample sizes should investigate the intersection of time perspective and acculturation on Generation Z adults’ cognition. More research that evaluates how acculturation influences cognition will help researchers and clinicians understand Spanish speakers’ cognition from a generational cohort perspective.
H - 55 Socially Responsible Neuropsychology (SRN) in Action: the Role of Neuropsychology in Autism Spectrum Disorder (ASD) Care, a Case Study of a Bilingual Latino Patient
Authors: Carollo-DuPrey Giselle , Yañez Janet J , Fernandez Vindia G 
Published: October 2023

Abstract

Objective
Latinx children with ASD are diagnosed 1–3 years later than their White counterparts and typically present with more severe symptoms at the time of assessment. Systemic barriers include language barriers, limited literacy about ASD, mental health stigma, mistrust in healthcare. Latinx children are at greater risk of misdiagnosis, delayed access to special education, limiting early intervention. Within neuropsychology, there are limited bicultural/bilingual neuropsychologists trained in autism evaluations, few Spanish ASD diagnostic tools, no bilingual norms, and little understanding regarding neuropsychologists’ role in providing autism evaluations to culturally/linguistically diverse children. This social injustice results in unmet needs and inequities in ASD care for Latinx children. We aim to illustrate how the SRN model increases equitable ASD care amongst Latinx children.

Method
SRN model was utilized in 11-year-old bilingual Latinx male by applying culturally responsive interview to identify systemic barriers and language use, and a model of language proficiency testing. Testing was primarily in English after verbal fluency measures established language dominance. Clinical decision making identified the need for autism evaluation using Autism Diagnostic Observation Schedule (ADOS-2).

Results
His cognitive profile showed word reading and motor inefficiencies. ADOS-2 identified deficits in communication, reciprocal social interaction, restricted and repetitive behavior. Neuropsychological assessment confirmed ASD and Developmental Coordination Disorder diagnosis.

Conclusion
His unremarkable neurocognitive profile suggested compensatory strategies may have masked symptoms. This case highlights need for bicultural/bilingual neuropsychologists with experience providing comprehensive ASD evaluations to practice from equitable framework, using the SRN model to enhance early detection, treatment recommendations, and advocacy for access to culturally/linguistically appropriate resources.
H - 56 Culturally-Responsive Neuropsychological Evaluations: Two Case Studies Demonstrating the Application of the ECLECTIC Framework in Pediatric Medical Populations
Authors: Costello Rosalia , Jordan Lizabeth L , Papadakis Jackie L , MacDonald Beatriz 
Published: October 2023

Abstract

Objective
This case series aimed to demonstrate the application of Dr. Daryl Fujii’s ECLECTIC model to pediatric neuropsychological evaluations. The ECLECTIC model identifies a wide range of social and cultural factors (e.g., bilingual language development, economic factors, and social determinants) that are integrated to provide patient-centered, culturally responsive neuropsychological services.

Methods
The application of the ECLECTIC model to pediatric evaluations will be reviewed. Two cases of pediatric patients with different levels of bilingualism (English/Spanish) and diagnoses of Spina Bifida (SB) will be presented. These cases will illustrate a range of cultural and social factors (including ethnic, linguistic, and economic factors) that impact a pediatric neuropsychological evaluation. Clinical considerations and practical solutions will be provided.

Results
The ECLECTIC model provides a framework for understanding and integrating social-cultural factors and the intersection of such factors in a pediatric neuropsychological evaluation. This is the first case series to demonstrate the use of the ECLECTIC model in a pediatric medical population.

Conclusions
With the aim of reducing existing healthcare disparities, a social-cultural lens is critical to conducting a neuropsychological evaluation, formulating diagnoses and conceptualization, and offering relevant and patient/family-centered recommendations.
H - 57 Case Study: Chinese Older Adult with Parkinson Disease and Visual Impairment Presenting for Pre-Deep Brain Stimulation Evaluation
Authors: Eisenstein Alexander , Bosch Chelsea , Bruger Bryanna 
Published: October 2023

Abstract

Objective
We present a case in which intersecting linguistic and disability factors necessitated a flexible, qualitative approach to clinical decision making in the context of pre-deep brain stimulation (DBS) evaluation.

Method
LZ is a 70-year-old, right-handed, cisgender, Chinese male with history of Parkinson disease (PD) presenting for DBS evaluation. Symptoms included right extremity tremor with decreased effectiveness from dopamine therapy. Cognitive, behavioral, personality, or functional changes were denied. He had severe visual impairment due to macular degeneration and cataracts. LZ immigrated to the U.S. 30 years prior and obtained a Ph.D. in Law. His English was not at the level of native speaker, but he declined use of an interpreter. Nevertheless, English proficiency was adequate to conduct testing.

Results
LZ’s premorbid functioning was estimated as average. Scores on attention/working memory and verbal fluency were intact. Processing speed and auditory naming were below average. Memory performance was characterized by inefficient learning and intact recall. Executive functions were variable in verbal set switching and motor sequencing was intact.

Conclusion
Typically, such a case with language/cultural differences would rely on more visuospatial than verbal tests; however, visual impairment necessitated reliance on verbal tests only. It was determined that variability of performances and low scores on naming were more likely attributable to language/cultural factors, and LZ was therefore deemed a good candidate for DBS surgery based on multiple intact cognitive abilities and strong social support. LZ received left subthalamic nucleus DBS. There was initial hemorrhagic complication during electrode placement resulting in language loss, which he recovered after five weeks.
H - 60 Navigating Cultural and Medical Factors in Pediatric Neuropsychological Assessment: a Case Study
Authors: Hammer Jasmine , Yund Brianna 
Published: October 2023

Abstract

Objective
The current case study focuses on a neurodevelopmental evaluation for a child with a complex medical history, suspected genetic disorder, and significant developmental delays within the context of cultural diversity, linguistic barriers, and interpretation services.

Methods
Patient is a 4-year-old male of Oromo decent who is exposed to both Oromo and English. Medical background is significant for congenital glaucoma and global developmental delay. He is nonverbal and uses few gestures to communicate. He presented with spastic motor movements and dysmorphic facial features. There is no history of genetic testing nor consults with neurology. Developmentally appropriate measure of neurocognitive functioning was administered with the use of an Oromo interpreter.

Results
Results revealed impaired performance within the areas of cognition, language, and motor functioning. Cognitive abilities measured similar to a 26-month-old. The patient’s social communication and emotional reciprocity varied; there was consideration of an autism spectrum disorder. Diagnostic challenges included medical complexity (i.e., vision differences with eye contact and visual referencing, motor functioning), unanswered diagnostic questions (i.e., underlying genetic or neurological condition), and cultural considerations. The evaluation yielded diagnoses of a global developmental delay and unspecified neurodevelopmental disorder. Recommendations included referrals to neurology, genetics, care coordination, and outpatient therapies.

Conclusion
Given the complexity of phenotypical behavioral manifestations of genetic disorders and cultural differences in terms of appropriate social behaviors convolute behaviors observed during the evaluation. The case study brings to light the consideration of cultural differences when interpreting behaviors as well as the value of a multidisciplinary approach to neuropsychological evaluation for diagnostic clarification.
H - 62 Current State of the Practice of Clinical Neuropsychology in Bolivia
Authors: Zarate Diego Jofre , Roth Eric , Calderón-Encinas Javier Fernando , Ramos-Usuga Daniela , Arango-Lasprilla Juan Carlos 
Published: October 2023

Abstract

Objective
The present study aimed to determine the current state of the practice of clinical neuropsychology in Bolivia.

Method
This is a descriptive and cross-sectional study. The sample consisted of 72 professionals working in the field of neuropsychology in Bolivia. The information was collected through an online questionnaire that included 70 questions about the participants’ professional training, professional practice, research, teaching, and perceived barriers to the profession’s development, among other factors.

Results
Approximately 76% of participants reported receiving postgraduate neuropsychology training. Their training was rated as very good (34.8%) and good (23.9%). Conversely, their clinical supervision was rated very good (24.3%) and good (33.3%). The participants indicated that their professional practice is conducted mainly in private settings (72.2%). Also, they mentioned that the most assessed disorders were learning disabilities (93.5%), intellectual disabilities (90%), and ADHD (87.5%). Similarly, the more frequent conditions rehabilitated were learning disabilities (23.6%), ADHD (20%), and depression (20.85%). Only 41.5% of the participants reported conducting research. A smaller proportion of professionals (31.5%) taught neuropsychology courses.

Conclusions
Neuropsychology is a relatively new field of work in Bolivia. For this reason, the participants considered that to enhance the quality of this specialty in Bolivia, new graduate programs in neuropsychology must be developed, more standardized tests validated, and more job positions created, especially in public institutions. Additionally, a professional organization that regulates the standards of this field needs to be established.
H - 64 When the Miranda Warning cannot be Understood: Implications of Utilizing an Unqualified Interpreter
Authors: Morales Sandra S , Cuellar Ruby , Renteria Laura 
Published: October 2023

Abstract

Introduction
Crenshaw (1989) identifies intersectionality as the interface between a person’s identities in relation to inequalities in social systems. She explicates how individuals receive distinct encounters with privilege and discrimination from society, depending on their unique amalgamation of personal, social, and political identities. An example of this is seen in a monolingual Spanish speaker of Mexican descent who underwent an independent neuropsychological evaluation to determine any cognitive impairment related to his legal charges.

Background
The defendant is a 39-year-old male with lifelong cognitive difficulties and one year of formal schooling. At the time of the arrest, he was interrogated with the assistance of an inexperienced, uncertified interpreter. Sight translation of the Miranda warning included 8 made-up words and multiple verb-tense errors, resulting in 15% + of the warning being nonsensical. The interview transcript indicated the defendant experienced frequent comprehension difficulties.

Test Results
The defendant is of extremely low intellectual abilities (FSIQ = 67, 1%ile). Cognitive deficits were observed across various domains including academic skills (reading, writing, math) and verbal comprehension. He is able to manage basic activities of daily living but needs assistance with more complex tasks (e.g., use of debit card, paying bills).

Conclusions
The evaluation suggests the defendant likely did not understand the Miranda warning and was swayed to confess during the interrogation. To combat institutional bias, law enforcement should be educated on individuals with lower cognitive capacities and the importance of accurate Spanish translation. Ignoring intersectionality and institutional bias perpetuates inequities in culturally appropriate care but can also contribute to wrongful convictions.
H - 66 A Systematic Review of Available Normative Data of Neuropsychological Tests for Latinx and Hispanic Samples
Authors: Perez-Lao Ambar , Arias Franchesca , Levy Shellie-Anne , Smith Glenn , Ying Gelan 
Published: October 2023

Abstract

Objective
This review aimed to examine and compare norm stratification of available normative data of neuropsychological tests for Spanish-speakers in the United States, Latin America, the Caribbean, and Spain.

Data Selection
English and Spanish studies focused on acquiring normative data for Latinx/Hispanics in Latin America, the Caribbean, the United States, and Spain, were searched from Embase, PubMed, PsycINFO APA, ClinicalTrials.gov, Science Direct, and ProQuest with the date before August 31st, 2022. We used the terms “Neuropsychological testing”, “Cognitive assessment”, “Hispanic”, “Latinx” and “Latinos”. Studies were imported to COVIDENCE, and reviewed by two Spanish-English bilingual reviewers, and one proficient English-only reviewer. Out of 345 records identified, 55 met inclusion and exclusion criteria and were not two standard deviations below the quality criteria index.

Data Synthesis
Age, education, and sex were the most common variables included in the stratification of normative data. Age was a predictor of lower performance in adults, and higher education was a predictor of better performance. With children and adolescents, increased age was related to better cognitive performance. Most of the studies were written in English and included a cognitively intact sample that was assessed either with the Mini-Mental State Examination, health history, or other clinical interviews or exams.

Conclusion
There is an evident improvement in the availability of measures for Spanish speakers. However, there is a need for better-developed tests for this population. Future studies in this area should consider adding variables such as acculturation and bilingualism into research, as well as developing novel measures for Spanish speakers.
H - 67 Socially Responsible Neuropsychology (SRN) in Action: Considering Culture, Brain Structure, and Function Longitudinally in an Atypical Pituitary Adenoma Case
Authors: Rivera Jesus M , Díaz-Santos Mirella , Suarez Paola A 
Published: October 2023

Abstract

Objective
Research on the neuropsychological profile associated with pituitary adenoma (PA) in diverse populations is limited. Clinically, PAs are categorized by size (micro-vs-macro) and hormone secretion levels (functional/secreting-vs-nonfunctional/non-secreting [NFPA]). Macro-NFPA are associated with visual–spatial, memory, and executive functioning declines, likely due to mass effects. No previous reports of cognitive declines in micro-NFPA were found in the literature. We present a clinical case illustrating the application of an SRN model in a 75-year-old, Spanish-English bilingual male, with cognitive declines, diagnosed with micro-NFPA.

Method
An SRN model was applied to promote equitable care through evidence-based consideration of neuropsychological syndromes in bilinguals, neurodiagnostics, and complex psychosocial factors. The patient underwent longitudinal language-congruent neuropsychological assessment and structural/functional neuroimaging. Educational background, linguistic proficiencies, acculturation level, social/behavioral comportment, and limitations in available neuropsychological tools/norms were integrated to reflect the complexity in conducting a reliable bilingual assessment and formulating differential diagnoses.

Results
The SRN model guided complex clinical decision-making. Neuropsychological profile (frontal-subcortical-vs-cortical-involvement) varied across language and time-point. Within/between variable performances in memory, executive functioning, processing speed, and verbal fluency were inconsistent with structural neuroimaging at assessment points, increasing diagnostic ambiguity. Advocated-for functional neuroimaging revealed pituitary hypometabolism.

Conclusions
To our knowledge, this is the first reported case of neurocognitive impairment in micro-NFPA, and the first reported neuropsychological profile of a bilingual individual with PA. The findings suggest the need for further research on neurocognitive declines in NFPA in diverse populations. It also highlights the importance of assessing in all relevant languages when conducting longitudinal assessments to boost sensitivity and specificity in differential diagnoses.