Neuropsychological assessment in middle childhood : objective and subjective assessment of executive and social functioning : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Wellington, New Zealand
This thesis presents a research study that aimed to explore measurement issues
in child neuropsychological assessment, within a NZ cultural context.
Neuropsychological assessment tools should be developmentally and culturally
appropriate, yet most measures used with NZ children have not been evaluated with this
population. Further, both subjective and objective assessment tools have been
developed, but it is unclear how information gained from these assessment tools relate
to each other and inform clinical practice.
Child neuropsychology has undergone many changes in recent years. With an
increasing understanding of autism spectrum disorders, new domains of functioning
have been introduced in neuropsychological assessment instruments, notably, executive
functioning (EF), theory of mind (ToM), and affect recognition (AR). Numerous
similarities have been documented between these constructs however, making
interpretation of assessment results complex. Though these constructs are thought to
develop across middle childhood, this population is vastly understudied.
This thesis aimed to evaluate patterns of performance on the BASC-2, BRIEF
and NEPSY-II measures with NZ school-aged children. Normative data for these
measures is not available for NZ children, therefore this research aimed to evaluate the
suitability of test norms for this demographic. Further, the thesis aimed to explore the
relationship between parent and teacher reports of function and evaluate how subjective
(broadband and narrowband) and objective measures of EF, ToM and AR are related.
Participants were 241 children from schools within the Wellington and Hawke’s Bay
regions, recruited as part of a larger study.
Ratings on the BASC-2 and BRIEF measures differed substantially from
American norms, with parents and teachers tending to report fewer problem behaviours
and more adaptive behaviours than their American counterparts. Results indicated a
discrepancy between parent and teacher reports, and between the information gained
from subjective versus objective measures. The results of this research have important
clinical implications not just for the use and interpretation of these measures, but also
for the neuropsychological assessment of EF, ToM and AR in NZ children.