Teresa Burke

A cognitive assessment strategy that is not limited to examining a set of summary test scores may be more helpful for early detection of emergent illness such as Alzheimer’s disease (AD) and may permit a better understanding of cognitive functions and dysfunctions in those with AD and other dementia disorders. A revisit of the work already undertaken by Kaplan and colleagues using the Boston Process-Approach provides a solid basis for identifying new opportunities to capture data on neurocognitive processes, test-taking strategies and response styles. Thus, this critical review will combine traditional process-based assessment strategies with support provided or offered by newer technologies that have the potential to add value to data collection and interpretation. There is now considerable interest in neuropsychological test administration using computer/digital technology, both in research and in clinical settings. To add value, any computerized version of an existing cognitive test should respect the administration procedure for which normative data were obtained, should be time-saving in terms of scoring and interpretation, and should, we argue, facilitate gathering information about the processes and strategies followed in test completion. This article will offer an overview of the steps needed when implementing computerization of neuropsychological tests using a Process-Based Approach (PBA) to these technology-based adaptations and will discuss further developments in this area by linking it to future technological developments that may be possible in the area of neuropsychological assessment. Additionally, an overview of neuropsychological tests that may benefit from computerization will be presented, together with suggestions on the specific processes, strategies and features that may be captured with the aid of such computerization. Finally, hypotheses on how virtual reality could be an asset for the future of the PBA to neuropsychological assessment will also be discussed.

A proliferation of tests exists for the assessment of auditory-verbal memory processes. However, from a clinical practice perspective, the situation is less clear when it comes to the ready availability of reliable and valid tests for the evaluation of visual/visuo-spatial memory processes. While, at face value, there appear to be a wide range of available tests of visual/visuo-spatial memory, utilizing different types of materials and assessment strategies, a number of criticisms have been, and arguably should be, leveled at the majority of these tests. The criticisms that have been directed toward what are typically considered to be visual/visuo-spatial memory tests, such as the potential for verbal mediation, over-abstraction of stimuli, the requirement of a drawing response, and the lack of sensitivity to unilateral brain lesions, mean that, in reality, the number of readily available valid tests of visual/visuo-spatial memory is, at best, limited. This article offers a critical, historical review on the existing measures and resources for the neuropsychological assessment of visual/visuo-spatial memory, and it showcases some examples of newer tests that have aimed to overcome the challenges of assessing these important aspects of memory. The article also identifies new trends and examples of how technological advances such as virtual reality may add value to overcome previous obstacles to assessment, thereby offering professionals more reliable, accurate means to evaluate visual/visuo-spatial memory in clinical practice.