Advanced Topics in Assessing Change in the Individual Patient

1.5 CE Credits

Presented by:
Kevin Duff Ph.D.
Professor of Neurology
Clinical Neuropsychologist
Center for Alzheimer's Care, Imaging, & Research
University of Utah

Serial neuropsychological assessments are complicated to interpret due to practice effects, regression to the mean, and “normal” change in clinical conditions. This webinar will build on the “introductory” session and address more nuanced issues in assessing cognitive change. It will start with a quick review of common statistical formulae for determining change (reliable change index, regression-based change formula), using case examples to demonstrate the strengths and weaknesses of each method. It will also address more complex issues in assessing change (e.g., applying methods to individual tests vs. an entire battery, examining change across more than two assessments, determining whether ±1.645 is the best cutoff, externally validating change scores). The webinar will end with a “call for future research,” as we discuss necessary future steps in the advancement of this area.

After the webinar, participants will be able to:

  1. Compare a wider range of mathematical formulae for assessing cognitive change.
  2. Apply methods for determining change in varied clinical scenarios.
  3. Discuss and explain critical issues in the advancement of this area in the future.

Target Audience: Practicing clinical and research neuropsychologists of all levels, including students and trainees, who are interested in better evaluating cognitive change in their patients or as part of research protocols. Taking the introductory session or having some existing knowledge of this topic area would be helpful.

Instructional Level: Advanced

About Kevin Duff, Ph.D.
Dr. Kevin Duff has specialized in neuropsychology for over 15 years. In 2009, he joined the University of Utah, where he is currently a Professor of Neurology and neuropsychologist for Alzheimer’s Care, Imaging and Research. He obtained his Ph.D. in Clinical Psychology from the State University of New York in Albany. He completed his neuropsychology internship at the Southern Arizona Healthcare System in Tucson, AZ, and his post-doctoral fellowship at the University of Oklahoma Health Sciences Center in Oklahoma City. He joined the Psychiatry Department at the University of Iowa in 2003, where had clinical and research responsibilities working with patients with dementia, Huntington’s disease, and a variety of other neuropsychiatric conditions. His current research has focused primarily on the early identification of cognitive decline in neuropsychiatric illnesses. Dr. Duff’s work has been widely published in scientific journals and he has lectured nationally and internationally on his areas of expertise. His research on Mild Cognitive Impairment has been funded by the National Institutes of Health since 2005.

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1.5 CE Credits

Presented by:
Robin L. Peterson, PhD, ABPP/CN
Pediatric Neuropsychologist
Department of Rehabilitation Medicine
Children’s Hospital Colorado







This workshop will begin with a brief overview of current scientific knowledge about learning disabilities (LDs) impacting reading, writing, and mathematics, including their etiology, brain bases, neuropsychology, and cross-cultural manifestations. We will review the evidence bearing on various diagnostic models, including age discrepancy, IQ discrepancy, patterns of strengths and weaknesses, and response to intervention.  The remainder of the workshop will focus on the implications of this scientific background for individual diagnosis and treatment planning. We will explore common diagnostic quandaries in LD assessment related to severity, specificity, base rates, and etiology and will briefly discuss evidence-based interventions for LDs.

After the webinar, participants will be able to: 
1. Discuss pros and cons of diagnostic models of learning disabilities (LDs), including age discrepancy, IQ discrepancy, patterns of strengths and weaknesses, and response to intervention.
2. Identify universals and cultural constraints in the manifestation of LDs across countries/languages as well as for different demographic groups within this country.
3. Describe the challenges of applying categorical diagnosis to a continuum of academic skill and discuss the implications for cases falling in the “gray area.”

Target Audience: Clinical neuropsychologists and neuropsychology trainees
Instructional Level: Introductory

Dr. Robin L. Peterson is a pediatric neuropsychologist at Children’s Hospital Colorado and Assistant Professor in the Department of Physical Medicine and Rehabilitation at the University of Colorado School of Medicine. She received a doctorate in child clinical psychology from the University of Denver and completed a postdoctoral fellowship in pediatric neuropsychology from the University of Denver and Children’s Hospital Colorado. She previously worked as director of the Developmental Neuropsychology Clinic at the University of Denver. She is board certified in Clinical Neuropsychology and Pediatric Clinical Neuropsychology through the American Board of Professional Psychology.  She has clinical and research interests in neurodevelopmental disorders and pediatric traumatic brain injury. She is currently a co-Investigator for the Colorado Learning Disabilities Research Center, which is funded by the National Institutes of Health. She is an author on over 20 peer-reviewed publications, multiple book chapters, and the book Diagnosing Learning Disorders: From Science to Practice (3rd Edition) which was published by Guilford Press earlier this year.  She recently served as invited chair for a symposium titled Cross-Cultural Perspectives on Reading Disabilities at the annual meeting of the International Neuropsychological Society. Before studying to be a psychologist, she taught kindergarten and first grade, which sparked her interest in understanding how all children learn to read. She remains active in teaching and training graduate students and postdoctoral fellows.

 
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Clinical Considerations for Neuropsychological Evaluation of Patients with Chronic Pain

1.5 CE Credits

Presented by:
Benjamin D. Hill, Ph.D.
Associate Professor, Department of Psychology
University of South Alabama



Jake Epker, Ph.D.
Private Practice
Jefferson Neurobehavioral Group

One of the challenges with investigating the influence of chronic pain on cognitive impairment is the fact that individuals with chronic pain often suffer from any number of other conditions, such as mood disturbance, somatization, sleep dysregulation, fatigue, or neurologic disease, that can independently impact cognitive functioning.  In addition, it has been suggested that some treatment for chronic pain, most notably opioid medication, can affect cognitive performance.  Finally, there is the possibility that the etiology, severity, and distribution of pain may differentially contribute to cognitive functioning.  Such complexities create a challenge for determining the extent to which chronic pain impacts cognitive functioning.  This webinar summarizes the research on such issues and then provides practical suggestions for the clinical assessment of patients with chronic pain.  

After the webinar, participants will be able to:

  1. Describe at least three biopsychosocial factors that the literature indicates negatively impact cognitive functioning among patients with chronic pain.
  2. List the cognitive domains for which there is greatest evidence in the literature for the presence of impairment among patients with chronic pain.
  3. Identify several assessment instruments that can assist the clinician in assessing a patient with chronic pain.

Target Audience: Clinical neuropsychologists who encounter chronic pain patients in their practice.

Instructional Level: Intermediate

About Benjamin D. Hill, Ph.D.
Dr. Hill earned a master’s degree in experimental psychology with an emphasis in psychophysiology from Wake Forest University and his clinical doctoral degree from Louisiana State University. He completed his internship at the University of Mississippi Medical Center and clinical fellowship in neuropsychology at the Warren Alpert Medical School of Brown University. His research interests broadly focus on psychometrics and cognitive assessment, how affect and personality impact cognitive performance, the effect of neuropathology and neurodegenerative diseases on fluid cognition, metabolic inflammation and cognitive health, and cognitive intra-individual variability as a marker of neuropathology. Dr. Hill is the statistical editor of Mindfulness, associate editor of Journal of Child and Family Studies, and on the editorial board of Journal of Attention Disorders.

About Jake Epker, Ph.D.
Dr. Epker earned his bachelor’s degree in psychology from Amherst College in Amherst, Massachusetts. He subsequently attended the University of Texas Southwestern Medical Center at Dallas, where he earned a Ph.D. in clinical psychology. His internship training focused on the application of psychology to patients with medical illness. Following graduation, Dr. Epker completed a two-year post-doctoral Fellowship in Health Psychology, with a focus on chronic pain.  He moved to Mobile, AL in September 2000.  His practice has primarily a behavioral medicine focus, with emphasis on the evaluation and treatment of individuals with chronic pain, including those being considered for procedures or surgery. In addition, Dr. Epker stays involved with teaching and research. He has published over a dozen articles and book chapters within the specialty of behavioral medicine and continues to lecture at various local and regional meetings on related topics.

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Driving and Neuropsychology: New Directions for Improved Assessment and Re-Training

1.5 CE Credits

Presented by:
Maria T. Schultheis, Ph.D.
Chair, Department of Psychology
Drexel University

The ability to drive an automobile is a complex activity that includes physical, cognitive, and behavioral demands.  The assessment of this ability after neurological compromise (e.g., from brain injury, stroke, or multiple sclerosis) is a challenging task faced by many clinicians. Yet, the role and contribution of the neuropsychologist in determining driving capacity has not been well-defined, despite the importance of cognition in driving. Overall, this course is designed to provide participants with a comprehensive review of the state of the science in regard to driving and neuropsychology.  Specifically, the course will include: 1) a brief overview of current clinical driver assessment procedures and strengths and weaknesses of current measurements of driving performance; 2) a review of common neuropsychological measures employed for driving assessment of neurological populations; and 3) a summary of the current research related to development of a virtual reality driving simulator to help address the need for new tools to support evidence-based recommendations of driving ability in neurological populations. 

After the webinar, participants will be able to:

  1. Describe the current methods for evaluating capacity to return to driving after neurological compromise.
  2. Identify three or four cognitive domains relevant to driving capacity, and list the neuropsychological tests in each domain used for assessment of driving.
  3. Discuss current research with virtual reality simulation and how it addresses the need for valid and objective measures of driving.

Target Audience: Neuropsychologists, psychologists, and graduate students interested in neuropsychology

Instructional Level: Introductory

About Maria T. Schultheis, Ph.D.
Dr. Schultheis is the Chair of the Department of Psychology and a tenured Professor with appointments in the Department of Psychology and in the School of Biomedical Engineering, Science and Health Systems at Drexel University in Philadelphia, Pennsylvania. Dr. Schultheis’ clinical and research experience have been focused on the rehabilitation of cognitively impaired populations, including traumatic brain injury, stroke and multiple sclerosis. Dr. Schultheis' overall interest is in research related to the investigation and development of methodologies that have functional significance and the application of technologies to address clinical needs. Dr. Schultheis' research has been consistently funded by such organizations as the National Institutes of Health (NIH) and the National Multiple Sclerosis Society (NMSS).  She has published over 100 publications, including a book entitled “The Handbook on Driving Assessment”. She has presented her work internationally and nationally across neuropsychological, rehabilitation medicine and transportation forums. Dr. Schultheis is the recipient of the 2007 American Psychological Association Early Career Award for Division 40 (Clinical Neuropsychology), a Fellow of Clinical Neuropsychology and in 2013 was honored as Mentor of the Year by the Philadelphia Neuropsychological Society. 

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DSM-5 and its Impact on Neuropsychological Assessment

1.5 CE Credits

Presented by:
Brian Yochim, Ph.D.
Mental Illness Research, Education, and Clinical Center (MIRECC), VA Palo Alto Health Care System
Clinical Assistant Professor (Affiliated), Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine

The DSM-5 contains substantial changes from the DSM-IV-TR that reflect increases in knowledge about conditions that affect cognition in adults.  This course will enable attendees to develop expertise in the DSM-5 diagnostic criteria for neurocognitive disorders (NCDs).  New diagnostic criteria for NCDs due to Alzheimer’s disease, frontotemporal degeneration, traumatic brain injuries, vascular disease, Lewy body disease, Parkinson’s disease, and other etiologies, and delirium, will be covered in depth.  The course will cover the diagnostic criteria for major and mild NCDs, the specifications for “probable” vs. “possible” causes of NCDs included in the DSM-5, and the six cognitive domains included in the DSM-5 to be assessed.  The webinar will focus on implications for neuropsychological assessment. 

After the webinar, participants will be able to:

  1. Describe the difference between mild vs. major Neurocognitive Disorder (NCD).
  2. Describe the diagnostic criteria among the different NCDs.
  3. Explain the diagnostic criteria for “probable” vs. “possible” causes of the different NCDs.
  4. Discuss implications for neuropsychological assessment of the different NCDs, including the six cognitive domains to be assessed in the diagnosis of NCD. 

Target Audience:This webinar will be targeted toward neuropsychologists who see primarily adult clients who wish to develop competency in using the DSM-5 to diagnose neurocognitive disorders.  Licensed professionals who wish to gain more expertise in DSM-5 nosology as well as postdoctoral fellows or interns will benefit from this webinar.

Instructional Level:Introductory

About Brian Yochim, Ph.D. 
Dr. Brian Yochim is a Board-Certified Clinical Neuropsychologist working in the Mental Illness Research, Education, and Clinical Center (MIRECC) at VA Palo Alto Health Care System in Palo Alto, California, where he conducts research on the neuropsychological assessment of older adults, with a focus on word-finding in patients with Alzheimer’s disease.  He also supervises postdoctoral fellows, interns, and practicum students performing neuropsychological evaluations for older Veterans.  He is a Clinical Assistant Professor (Affiliated) in the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine.  He obtained his PhD in clinical psychology at Wayne State University, completed an internship at VA Palo Alto Health Care System, and a postdoctoral fellowship in clinical neuropsychology at VA Northern California Health Care System.  He is the lead author of the Neurocognitive Disorders chapter of the forthcoming DSM-5 Study Guide.

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Effective Use of a Medical Interpreters in a Neuropsychological Evaluation

1.5 CE Credits


                                       
Presented by:
Margaret Lanca, Ph.D.
Director of Adult Neuropsychology and Psychological Testing and Training, Cambridge Health Alliance
Assistant Professor of Psychology, Department of Psychiatry, Harvard Medical School
 






Although there is a general consensus in neuropsychology that “best practice” for evaluating patients with limited English proficiency is to have bilingual/bicultural neuropsychologists, there are instances when this ideal is not attainable.  With the rise of multicultural evaluations in our profession, many neuropsychologists are using medical interpreters.  Interpreters both facilitate and pose challenges to an assessment.  This webinar will describe a framework for using interpreters most effectively within a culturally-informed neuropsychological evaluation and avoiding common pitfalls that can negatively impact an evaluation.  Topics of effective interpreter use at each stage of an assessment will be presented, highlighting general constraints of a multicultural assessment and how they interface with interpreter use.  A brief interview with an experienced medical interpreter for neuropsychological testing will provide practical insights for improving interpreter preparation and skill-level for neuropsychological evaluations.

After the webinar, participants will be able to: 
1. Outline considerations for electing to use a medical interpreter in a neuropsychological evaluation.
2. Describe elements of culturally-informed assessments and how interpreters interface within the cultural context.
3. Discuss effective strategies and common pitfalls of interpreter use at each stage of an assessment.

Target Audience: Clinical neuropsychologists and neuropsychology trainees
Instructional Level: Introductory

Dr. Maggie Lanca is the Director of Adult Neuropsychology and Psychological Testing and Training at Cambridge Health Alliance (CHA) in Cambridge Massachusetts and Assistant Professor of Psychology in Psychiatry at Harvard Medical School.  At Cambridge Health Alliance, Maggie directs the neuropsychology service and oversees training of the neuropsychology intern and postdoctoral fellows.  She teaches in the Psychiatry department and she frequently lectures at Harvard Medical School on neuropsychology.  Her teaching reflects her interests and specialties in cross-cultural neuropsychology.  Her clinical and teaching scholarship has focused neuropsychological assessment patients of different ethnicities and languages and she frequently conducts assessments in Portuguese, her native language.  She has spoken nationally and published on cross-cultural neuropsychology.  In addition to her academic and clinical work, Maggie is committed to the advancement of our field and has been involved in professional advocacy for psychology through various committees and boards.  She is currently the President of the Massachusetts Psychological Association and Past President of the Massachusetts Neuropsychological Society.

 

 

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Evolving Neuropsychological Considerations and Case Studies of Individuals who Identify as Transgender and Gender Non-Binary/Nonconforming

1.5 CE Credit

 

Presented by:
Michelle Cuevas, Ph.D. | Kaiser Permanente-Otay Mesa Clinic
Krista Freece, Ph.D., ABN | Kaiser Permanente- San Diego, CA  
Jeffrey Ryan Murray, Psy.D. | Kaiser Permanente – Vallejo, CA

Individuals who identify as transgender (TG) and gender non-binary/nonconforming (NB/NC) face various medical, psychiatric, and social barriers. Specific to medical transition, there appears to be a rise in those seeking support related to gender-affirming medical and surgical interventions. However, the transition process requires a medical regimen that includes the use of hormone blockers and/or hormone replacement therapy (HRT), which can begin several years prior to surgery with ongoing sequelae well after transition has completed. While the World Professional Association for Transgender Health (WPATH) Standards of Care are the established guidelines for HRT within the TG and NB/NC population, they are not rigid, and HRT can be individualized based on anatomic, social, and/or psychological variables. Given the potential variability of when HRT is started, what type of HRT is implemented, and the duration of HRT over the lifespan, these variants in regimen can have significantly different impacts on psychiatric and neuropsychological health, including neurodevelopment, cognitive functioning, and neurodegeneration. In the context of understanding how transition may impact neuropsychological functioning, we will discuss the evolving best practice guidelines for selecting comparison data for cognitive and psychological measures as part of a neuropsychological assessment. We will conclude by discussing two clinical cases which differed in stage of life and transition (including TG vs. NB/NC). We will discuss how the results of neuropsychological testing impacted the transition process and how neuropsychologists can stay ahead of the curve in treating this population.

After the session, participants will be able to:

1. Describe WPATH guidelines as they relate to the assessment and evaluation for Gender Dysphoria and readiness for medical transition.
2. List at least three gender-specific neurological differences in individuals who identify as TG and NB/NC, as well as changes pre- and post-hormone treatment (e.g., HRT).
3. Select appropriate comparison group data for cognitive and emotional measures based on the referral question, stage of medical transition, and unique characteristics of each examinee.
4. Utilize information from this seminar to improve approaches to neuropsychological evaluation with individuals who identify as transgender or non-binary/nonconforming across various stages of transition.

Target Audience: Neuropsychologists and graduate-level neuropsychology students

Instructional Level: Intermediate

Michelle Cuevas, Ph.D. is a clinical child and adolescent psychologist for Kaiser Permanente in San Diego. She is also a clinical supervisor for their APA-accredited predoctoral internship program. Her research and current clinical interests include neuropsychological/psychodiagnostic assessment; neurodevelopmental disorders, parent training and psychoeducation, learning disabilities, diversity/multicultural issues, and evidence-based treatments. Her clinical and research experiences include program development for a regional center, bedside assessment in rehabilitation settings, consultation and assessments for the Department of Education, assessment, treatment, and program development for the Department of Developmental Services, and assessment and research in pediatric cancer survivorship through the City of Hope.

Krista Freece, Ph.D., ABN earned her doctorate from Fielding Graduate University with an emphasis in neuropsychology. She earned board certification in neuropsychology in 2015 and currently serves as a work sample reviewer for the American Board of Professional Neuropsychology.  She works for Kaiser Permanente in San Diego, and her clinical focus is on neuropsychological assessment of individuals with a broad range of presenting problems including dementia, stroke and traumatic brain injury.  Dr. Freece’s clinical training in psychotherapy includes experience in Prolonged Exposure and Cognitive Processing Therapy for treatment of Posttraumatic Stress Disorder.

Jeffrey Murray, Psy.D. is currently a first year neuropsychology postdoctoral fellow in the neuropsychology department at the Kaiser Foundation Rehabilitation Center in Vallejo, California. Prior to his fellowship, Jeffrey completed his APA-accredited internship with Kaiser Permanente - San Diego. Prior to internship, Jeffrey completed practicum training in the neuropsychology department at the Loma Linda University Medical Center and the UCLA Semel Institute performing inpatient and outpatient neuropsychological evaluations and brief therapy.  

 

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Introduction to Assessing Change in the Individual Patient

1.5 CE Credits

Presented by:
Kevin Duff Ph.D.
Professor of Neurology
Clinical Neuropsychologist
Center for Alzheimer's Care, Imaging, & Research
University of Utah

Repeated neuropsychological assessments are frequently used in clinical practice to track progression of an illness or chart response to an intervention. However, the interpretation of repeated cognitive test scores can be tricky, and there is limited guidance on this topic. This webinar will introduce attendees to basic concepts associated with change, including test variables (e.g., reliability, practice effects), testing situation variables (e.g., retest interval), and individual variables (e.g., demographics, clinical conditions). Participants will also be introduced to common methods of assessing change (e.g., alternate forms, reliable change index, regression-based change formulae). Case examples will be used to guide the presentation.

After the webinar, participants will be able to:

  1. Describe the role that test variables, testing situation variables, and individual variables have on assessing cognitive change.
  2. List common methods for assessing change in patients.
  3. Compute and apply basic mathematical formulae for assessing cognitive change.

Target Audience: Practicing clinical and research neuropsychologists of all levels, including students and trainees, who are interested in better evaluating cognitive change in their patients or as part of research protocols.

Instructional Level: Introductory

About Kevin Duff, Ph.D.
Dr. Kevin Duff has specialized in neuropsychology for over 15 years. In 2009, he joined the University of Utah, where he is currently a Professor of Neurology and neuropsychologist for Alzheimer’s Care, Imaging and Research. He obtained his Ph.D. in Clinical Psychology from the State University of New York in Albany. He completed his neuropsychology internship at the Southern Arizona Healthcare System in Tucson, AZ, and his post-doctoral fellowship at the University of Oklahoma Health Sciences Center in Oklahoma City. He joined the Psychiatry Department at the University of Iowa in 2003, where had clinical and research responsibilities working with patients with dementia, Huntington’s disease, and a variety of other neuropsychiatric conditions. His current research has focused primarily on the early identification of cognitive decline in neuropsychiatric illnesses. Dr. Duff’s work has been widely published in scientific journals and he has lectured nationally and internationally on his areas of expertise. His research on Mild Cognitive Impairment has been funded by the National Institutes of Health since 2005.

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Neuropsychological Assessment of Transgender Individuals Across the Lifespan: Care Considerations

1.5 CE Credits

 

Presented by:
Emily H. Trittschuh, PhD
Clinical Neuropsychologist with the VA Puget Sound Health Care System’s Geriatric Research Education Clinical Center (GRECC)

Felice Orlich, PhD
Clinical Professor, University of Washington, Psychiatry and Behavioral Sciences
Seattle, WA

Affirmative care for all individuals is a core value among neuropsychologists.  The unique social challenges and associated health disparities found among transgender individuals represents a” call to action.” The purpose of this webinar is to highlight research and clinical care considerations for neuropsychological assessment of gender diverse individuals across the lifespan. Affirmative terminology and prevalence data will be presented. The limited academic literature will be reviewed, and gaps in knowledge and methodology will be discussed. Important bio-psycho-social factors, as well as developmental approaches to gender identity development, will be described.

After the webinar, participants will be able to:

1. Identify pertinent bio-psycho-social variables which may be critical when conducting neuropsychological evaluation and/or research in individuals who are gender diverse.
2. Explain the importance of gender identity development in neuropsychological assessment.
3. Describe gender variance in youth and co-occurring mental health and neurodevelopmental disorders.


Target Audience:
Neuropsychology trainees (graduate students, interns, and fellows) and neuropsychologists (clinical/academic)

Instructional Level: Introductory

Emily Trittschuh, PhD, is a Clinical Neuropsychologist with the VA Puget Sound Health Care System’s Geriatric Research Education Clinical Center (GRECC) and is an Associate Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine. She has specialized in issues pertinent to aging and neurodegenerative disease throughout her career. Since joining the VA in 2008, she has developed additional and complementary interests in the care of older Veterans with PTSD, especially with respect to how this disorder can interfere with cognition and might contribute to decline, as well as neuropsychological assessment of Veterans who do not identify with their assigned gender at birth.

Dr. Orlich’s research and clinical work focuses on the assessment and treatment of youth and families with autism spectrum disorder (ASD) with a focus on defining treatment pathways matched to their individual needs. Dr. Orlich has been the principal investigator on an NICHD funded randomized clinical trial of social skills intervention for youth with ASD and the lead investigator on the AIR-B school-based interventions and outcome assessment for underserved youth with ASD. As an extension of this work, she is the principal investigator on a multidisciplinary project addressing the development of assessment tools and treatment parameters for gender diverse youth with ASD. Dr. Orlich is a Clinical Professor in the University of Washington Department of Psychiatry and Behavioral Sciences. She is an attending psychologist at Seattle Children’s Hospital, where she primarily focuses on training and neuropsychological assessment of youth with ASD. She brings expertise in diverse intervention approaches, training and research in ASD with a strong focus on patient centered outcomes within communities of underserved families.

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Performance Validity Testing in Children and Adolescents: The State of the Science & Considerations for Practice


Michael W. Kirkwood, Ph.D., ABPP/CN 

Director, Rehabilitation Psychology & Neuropsychology
Co-Director, Concussion program
Department of Rehabilitation Medicine
Children’s Hospital Colorado











Research on methodologies to identify performance invalidity in children has lagged behind that for adults. Even so, multiple performance validity tests have now been shown to be appropriate for use in younger populations. This workshop will review the empirically supported options and provide a rationale for including objective performance validity tests when putting together any school-age test battery. Data will be presented to demonstrate that noncredible effort occurs consistently in pediatric populations. Case examples will highlight some of the many reasons children display noncredible presentations. How practitioners can address noncredible effort once it is identified will also be discussed, including a model for delivering clinical feedback to parents and children.


 After the webinar, participants will be able to:

1. Describe studies that have investigated the base rate of noncredible effort in children presenting for neuropsychological exam.
2. Discuss performance validity tests that have been studied empirically in pediatric samples.
3. Apply strategies when invalid responding occurs.

Target Audience: Advanced trainees and providers conducting neuropsychological assessments with children and adolescents.

Instructional Level: Intermediate

Dr. Kirkwood is a board-certified pediatric neuropsychologist and Associate Professor in the Department of Physical Medicine & Rehabilitation at the University of Colorado School of Medicine. He is the Director of Rehabilitation Psychology & Neuropsychology at Children’s Hospital Colorado and is the founder and co-director of the hospital’s Concussion Program. He has particular interest in pediatric validity testing and pediatric TBI, presenting nationally and internationally on the topics and serving on multiple expert panels and committees. His research has been funded by numerous organizations, and he has authored over 100 scientific articles and book chapters. He is also the author/editor of six scientific books, including one on validity testing in children and adolescents.

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Seeing the Forest for the Trees: Improving Accuracy of Test Interpretation for Clinicians and Researchers

1.5 CE Credits

Presented by:
Brian L. Brooks, Ph.D.
Director of Neuropsychology
Alberta Children's Hospital

Neuropsychologists administer and interpret a large number of tests during an assessment. It can be under-appreciated, however, that interpreting multiple test scores is different than interpreting a single test score. Multiple scores have scatter, intra-individual variability, and higher prevalence rates of ‘abnormal’ findings than a single score, so they must be interpreted simultaneously (i.e., multivariate base rates; MVBRs). This webinar will review the psychometric principles associated with MVBRs of low scores: (1) low scores are common across all test batteries; (2) the number of low scores depends on the cutscore used; (3) the number of low scores depends on the number of tests administered; (4) the number of low scores varies by examinees’ demographics; and (5) the number of low scores varies by examinees’ intelligence. Examples using pediatric, adult, and older adult data will demonstrate these principles. Newer studies considering the MVBRs of reliable change scores will also be introduced.

After the webinar, participants will be able to:
  1. Describe the psychometric principles for interpreting multiple test scores.
  2. Explain that there is variability in test scores and that low scores are common in healthy people.
  3. Apply multivariate base rates in everyday clinical practice as an interpretive technique to reduce misdiagnoses of cognitive impairment.
  4. Critique the practice of over-interpreting an isolated low score.

Target Audience: Neuropsychologists and psychologists at all career levels who assess children, young adults, and older adults

Instructional Level: Intermediate

Brian L. Brooks, Ph.D. is a pediatric neuropsychologist and director of neuropsychology services at the Alberta Children’s Hospital in Calgary, Alberta, Canada. He is also an adjunct faculty member with the Departments of Pediatrics, Clinical Neurosciences, and Psychology at the University of Calgary, a full member with the Alberta Children’s Hospital Research Institute, an associate member of the Hotchkiss Brain Institute, and the research lead for the Alberta Children’s Hospital Complex Concussion Clinic. His primary research focus is on neuropsychological outcomes from concussion, including early diagnosis, prognostication of outcome, potential treatment options, and long-term effects. He has over 100 peer-reviewed journal publications in the field of neuropsychology, including papers on psychometrics, test interpretation, performance validity testing, and outcomes from various medical, neurological, and psychiatric diseases. He is the co-author of three neuropsychological measures (ChAMPMVP, and MEMRY) and is the co-editor of the first pediatric-focused forensic textbook, Pediatric Forensic Neuropsychology. He has been recognized with several distinctions from the National Academy of Neuropsychology, including twice receiving the Nelson Butters award 2010 and 2014, receiving the early career award in 2014, and being elected as a fellow in 2015. He is currently supported by an Embedded Clinician Researcher award from the Canadian Institutes of Health Research (CIHR).

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Neuropsychological Assessment of Hispanics Residing in the US: Ingles, Español o dos? (English, Spanish or both?)

1.5 CE Credits

Presented by:

Antonio Puente, Ph.D.

Adriana Strutt, Ph.D.

This webinar is designed to help students, early career neuropsychologists and seasoned practitioners recognize the complexities involved in the comprehensive assessment of Hispanics residing in the United States. Material will be relevant to both clinical providers and researchers.  The influence of socio-demographic variables and psychosocial factors on neurocognitive performance and outcome measures will be examined.  Barriers (including minimal assessment tools and normative data) in providing competent neurocognitive evaluations for this population will be discussed.  Progress in the evolving subspecialty of Hispanic Neuropsychology will be reviewed, including recent developments in testing standards and guidelines.  Potential solutions for clinical and research settings will be offered.  Examiner and examinee variables to consider when working with Hispanics will be discussed and an empirically based decision-making process approach for the assessment of diverse clients in the U.S. will be provided. 

After the webinar, participants will be able to:

  1. Explain the effect of socio-demographic and psychosocial factors, including linguistic and cultural variables, on neuropsychological performance and outcome measures, and the common challenges faced by those who serve Hispanics in clinical and research arenas
  2. Utilize an empirically based decision-making process approach for use with culturally and linguistically diverse populations that includes resources for test development and translations and cultural modifications
  3. Recognize the influence of examinee and examiner variables on neuropsychological and psychological outcomes
  4. Apply new testing standards to culturally and linguistically dissimilar individuals
Target Audience:
  • Students of all levels interested in the subspecialty of cross-cultural neuropsychology
  • From students to experienced neuropsychologists
  • Clinicians and researchers working with Hispanics across the life span and with clients of varying degrees of language mastery (English speaking, bilingual and monolingual Spanish-speakers)
Instructional Level of Presentation:This webinar is designed to be of benefit to students, early career neuropsychologists and seasoned practitioners.  Material presented provides the learner with a summary of the evolving subspecialty of Hispanic Neuropsychology.  A foundation regarding socio-demographics and psychosocial variables that influence cognitive performance is provided for those early in their careers.  Novel resources and references are provided, which will be of benefit to the more advanced and experienced clinicians and researchers.  Overall, a comprehensive webinar that will be of benefit to practitioners with varying levels of experience.

About Antonio Puente, Ph.D.

Antonio Puente, born in La Habana, Cuba, received his undergraduate degree in psychology from the University of Florida and his graduate degrees from the University of Georgia. He is currently Professor of Psychology at the University of North Carolina Wilmington and maintains a private practice for clinical neuropsychology. He is the founder and co-director of the Cape Fear Clinic, a bilingual mental health clinic for the poor and uninsured. He is widely published in English and in Spanish, and he is the founder and editor of the quarterly scientific journal,Neuropsychology Review, as well as a book series in clinical neuropsychology. Dr. Puente is Past-President of the Hispanic Neuropsychological Society, National Academy of Neuropsychology, North Carolina Psychological Association, North Carolina Psychological Foundation, and Division 40 (Clinical Neuropsychology) of the American Psychological Association (APA), where he also served two terms as a Council of Representatives (40). He has chaired the Psychology Academy of the National Academies of Practice as well as several APA Boards and Committees, currently on the Joint Committee for Standards for Educational and Psychological Tests. Puente was APA’s representative to the American Medical Association’s Current Procedural Terminology panel from 1993 to 2008, when he was elected to the Editorial Panel of the CPT (voting member to 2016). Puente was a Fulbright Scholar in 1983 (Argentina), NCPA and NAN’s Lifetime Service Achievement Award recipient, and he received the APA’s Distinguished Professional Contributions to Independent Practice in 2011.

About Adriana Strutt, Ph.D.

Adriana Macias Strutt completed her undergraduate degree at the University of La Verne in La Verne, California.  She earned a Master’s degree in experimental psychology and a doctorate in clinical psychology with an emphasis in neuropsychology from Loma Linda University in Loma Linda, California.  She completed her APA approved internship and fellowship in neuropsychology at Baylor College of Medicine (BCM) in Houston, Texas and has been a faculty member at BCM since 2008. She is presently an Assistant Professor in the departments of Neurology and Psychiatry & Behavioral Sciences.  She is bilingual and board certified in clinical neuropsychology.  Dr. Strutt is the recipient of two Fulbright & Jaworski LLP Faculty Excellence Awards (Teaching & Evaluation and Enduring Materials) and a member of BCM’s Academy of Distinguished Educators.  She provides clinical and forensic neuropsychological assessment for English and Spanish speaking children, adults and geriatrics who suffer from a myriad of neurological conditions.  She also conducts clinical research with an emphasis in neurodegenerative disorders and is involved in neuropsychological test development and validation. 

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